On the Bleeding Edge: Mastering GI Emergencies and Inpatient GI Consultation (On-Demand) | 2026-Course Overview and Non-Variceal UGIB Hemostasis

Video Transcription

Video Summary

The inaugural ASGE course for GI hospitalists encouraged participants to visit vendors, complete CME requirements, and actively share questions and practical experience. Organizers described “bleeding-edge” practice as the judgment and creativity needed to manage real-world problems beyond formal guidelines.<br /><br />The first lecture reviewed non-variceal upper GI bleeding. Endoscopy is generally recommended within 24 hours, after resuscitation and attention to comorbidities; rushing unstable patients to endoscopy may be harmful. Standard hemostatic options include thermal therapy, clips, and combination therapy with epinephrine (never epinephrine alone). Evidence for newer topical agents is evolving: hemostatic powder can help with active bleeding and tumor-related bleeding, while over-the-scope clips may be useful for selected high-risk lesions or recurrent bleeding.<br /><br />After successful treatment of high-risk ulcers, give high-dose PPI therapy for three days, then continue twice-daily dosing for at least two weeks. For recurrent bleeding, repeat endoscopy; if endoscopic treatment fails, consider interventional radiology.<br /><br />For patients taking antithrombotic medication, minimize interruption when possible. Continue aspirin used for secondary cardiovascular prevention, and resume interrupted therapy promptly after hemostasis. For apixaban and other anticoagulants, timing is uncertain, but restarting within seven days is generally favored.

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Loren Laine, MD

Keywords

GI hospitalist

upper GI bleeding

endoscopy

hemostatic therapy

proton pump inhibitor

antithrombotic management

anticoagulants

GI hospitalists

interventional radiology