ASGE Postgraduate Course at ACG 2022: Expanding the Scope of Fundamental and Advanced Endoscopy (On-Demand) | October 2022-State of the Art Lecture: Risk Stratification and Treatment of UGI Bleeding

Video Transcription

Video Summary

The video features Alan Barkin, a professor at McGill University and Montreal General Hospital, giving a state-of-the-art lecture on risk stratification and treatment of upper GI bleed. He bases his recommendations on various guidelines, including the 2019 Multi-Society, Multi-Country Guidelines published in the Annals of Natural Medicine, as well as more recent guidelines from the ESGE and ACG. Barkin discusses the decreasing mortality rate of non-varicoseal upper GI bleeding, which is primarily related to comorbid illnesses such as malignancy and chronic kidney disease. He emphasizes the importance of endoscopic hemostasis as the cornerstone of therapy and the use of PPIs as an adjuvant for patients who have undergone successful endoscopic hemostasis. Barkin discusses the Glasgow Blatchford score for risk assessment and suggests that patients with a score of zero or one can be safely discharged home with outpatient follow-up and scoped as an outpatient. He also covers topics such as NG tube placement, transfusion thresholds, prokinetic therapy, endoscopic timing, and various endoscopic treatment modalities like bipolar electrocoagulation, over-the-scope clips, and hemostatic powders and gels. Barkin concludes by discussing peri-endoscopic management of patients on antithrombotic therapy and the importance of H. pylori eradication and PPI use for patients on dual antiplatelet therapy or anticoagulant therapy. Overall, the video provides a comprehensive overview of risk stratification and treatment options for upper GI bleed.

Asset Subtitle

Alan N. Barkum, MD, CM, MSc, FASGE, FACG

Keywords

upper GI bleed

endoscopic hemostasis

Glasgow Blatchford score

outpatient follow-up

endoscopic treatment modalities

antithrombotic therapy