Nonvariceal upper gastrointestinal bleeding

Carlos Rollhauser, D. E. Fleischer

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Nonvariceal upper gastrointestinal bleeding (NVUGIB) remains an important cause of morbidity and mortality. The etiological role and the relative risk of nonsteroidal anti-inflammatory drugs (NSAIDs) in association with other clinical factors are the focus of several papers published in the last year. Data from studies that evaluate the interaction of NSAIDs with Helicobacter pylori suggest that there is a clear role for eradication in aspirin-related bleeding. Although the benefit of H. pylori eradication in nonaspirin NSAID-related bleeding is being debated, they should both be eliminated given their relative contribution to the causation of peptic ulcer hemorrhage. The search for reliable and accurate tools to predict outcomes after NVUGIB continues. Recent important contributions in this area of research are the use of a clinical prediction guide to identify patients who are likely to require endoscopic intervention, and the use of Doppler ultrasound examination of the ulcer base to predict rebleeding. The role of antisecretory therapy in the setting of acute NVUGIB has been revisited in two meta-analyses and one randomized, placebo-controlled trial of omeprazole as an adjunct to endoscopic intervention. Until more definitive data are available, it appears that the effect of acid-decreasing medications is more important when endoscopic therapy is not provided than when effective endoscopic intervention is instituted. With regard to therapeutic endoscopy for upper gastrointestinal bleeding, the few randomized trials that have been published in full form in the last year focus on the use of mechanical methods of hemostasis for peptic ulcer bleeding and other etiologies such as Mallory-Weiss tears and Dieulafoy lesions.

Original languageEnglish (US)
Pages (from-to)111-118
Number of pages8
JournalEndoscopy
Volume34
Issue number2
DOIs
StatePublished - 2002

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Hemorrhage
Anti-Inflammatory Agents
Helicobacter pylori
Peptic Ulcer Hemorrhage
Mallory-Weiss Syndrome
Pharmaceutical Preparations
Doppler Ultrasonography
Gastrointestinal Endoscopy
Omeprazole
Hemostasis
Peptic Ulcer
Causality
Aspirin
Ulcer
Meta-Analysis
Therapeutics
Randomized Controlled Trials
Placebos
Morbidity
Acids

ASJC Scopus subject areas

  • Medicine (miscellaneous)

Cite this

Rollhauser, C., & Fleischer, D. E. (2002). Nonvariceal upper gastrointestinal bleeding. Endoscopy, 34(2), 111-118. https://doi.org/10.1055/s-2002-19853

Nonvariceal upper gastrointestinal bleeding. / Rollhauser, Carlos; Fleischer, D. E.

In: Endoscopy, Vol. 34, No. 2, 2002, p. 111-118.

Research output: Contribution to journalArticle

Rollhauser, C & Fleischer, DE 2002, 'Nonvariceal upper gastrointestinal bleeding', Endoscopy, vol. 34, no. 2, pp. 111-118. https://doi.org/10.1055/s-2002-19853
Rollhauser, Carlos ; Fleischer, D. E. / Nonvariceal upper gastrointestinal bleeding. In: Endoscopy. 2002 ; Vol. 34, No. 2. pp. 111-118.
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