ASGE Annual Postgraduate Course Endoscopy 2022 (On-Demand): Breakthrough to Excellence-Christie

Christie_GI Bleeding

Pdf Summary

This document summarizes a talk on controlling gastrointestinal (GI) bleeding by following guidelines presented by Jennifer Christie, MD. GI bleeding is a common problem, with around 500,000 hospitalizations per year in the United States. Approximately 70% of acute GI bleeds are upper gastrointestinal bleeds. The talk highlights the importance of risk stratification, initial management, and the role of endoscopy in controlling GI bleeding. It also reviews guidelines on recommended hemostatic techniques and post-endoscopy management.<br /><br />The presentation emphasizes several key points. Risk stratification of patients with acute GI bleeding is crucial for effective management. The Glasgow-Blatchford Score is a useful tool for risk assessment. Transfusion should be restricted to a lower hemoglobin threshold (7-8 g/dL) unless there are specific indications. Endoscopy should be performed within 24 hours of presentation for optimal outcomes. High-dose proton pump inhibitors (PPIs) given for at least three days after endoscopic intervention for peptic ulcer disease can significantly decrease further bleeding, mortality, and the need for surgery. Repeat endoscopy may be necessary in cases of recurrent bleeding, and surgery or interventional radiology procedures should be considered for high-risk patients or ongoing bleeding.<br /><br />The document also briefly mentions guidelines for controlling lower GI bleeding, with considerations for diverticulosis, colitis, hemorrhoids, and other causes. In cases of small bowel bleeding, multiple diagnostic techniques such as video capsule endoscopy and deep enteroscopy may be employed.<br /><br />The talk provides references to additional resources and studies that support the guidelines discussed. It concludes by thanking the audience for their attention.

Keywords

GI bleeding

gastrointestinal bleeding

endoscopy

hemostatic techniques

risk stratification

proton pump inhibitors

recurring bleeding

surgery

lower GI bleeding

small bowel bleeding