ASGE Postgraduate Course at ACG: Evidence-based Updates for the Practicing Gastroenterologist (On-Demand) | October 2021 OLPGATACG21-Non-variceal Upper GI Bleeding: What You Need to Know in 2021

Video Transcription

Video Summary

Dr. Professor Barkan is speaking on non-variceal upper GI bleeding and what we need to know in 2021. He refers to the annals and ACG guidelines and discusses important considerations in managing upper GI bleeding. He highlights that mortality from non-variceal upper GI bleeding has decreased over the past decade and is related to comorbid illnesses. Endoscopic hemostasis is the cornerstone of therapy, and PPIs may be considered as an adjuvant. Dr. Barkan discusses the Glasgow Blatchford score and how it can be used to classify patients as low risk and potentially send them home. He also discusses transfusion thresholds, pre-endoscopic therapy with erythromycin, and the timing of endoscopy. Dr. Barkan provides recommendations for endoscopic therapies for different types of bleeding ulcers, including bipolar electrocoagulation, heater probe, absolute ethanol injection, clips, and APC. He also discusses the use of hemostatic powders and gels, as well as over-the-scope clips. Dr. Barkan recommends high-dose PPI therapy for three days and provides recommendations for post-endoscopic and post-therapy PPI therapy. He also discusses H. pylori eradication and the continued use of PPIs in patients receiving cardiovascular prophylaxis. In conclusion, Dr. Barkan provides a summary of the key recommendations for managing non-variceal upper GI bleeding.

Asset Subtitle

Alan N. Barkun, MD, CM, MSc, FASGE

Keywords

non-variceal upper GI bleeding

endoscopic hemostasis

Glasgow Blatchford score

PPIs

endoscopic therapies

H. pylori eradication