Summary
Clinical practice guidelines for managing nonvariceal upper gastrointestinal bleeding
Gallach M, Calvet X, Lanas A, Feu F, Ponce J, Gisbert JP, Brullet E, Piñera P, Castro M, Martín de Argila C, Domínguez Muñoz E, Almela P, Villanueva C, González Galilea A, Pérez Aisa A, García-Iglesias P, Gené E, Villoria A, Barkun A
Affiliation of the authors
Servicio de Urgencias, Servicio de Aparato Digestivo, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Servicio de Aparato Digestivo, Hospital Clínico Universitario, Zaragoza, Spain. Servicio de Gastroenterología, Hospital Clínic, Barcelona, Spain. Servicio de Medicina Digestiva, Hospital La Fe, Valencia, Spain. Servicio de Aparato Digestivo, Hospital de la Princesa, Instituto de Investigación Sanitaria Princesa, Madrid, Spain. Servicio de Urgencias, Hospital Reina Sofía, Murcia, Spain. Servicio de Digestivo, Hospital Ntra. Sra. De Valme, Sevilla, Spain. Servicio de Gastroenterología, Hospital Ramón y Cajal, Madrid, Spain. Servicio de Aparato Digestivo, Hospital Clínico Universitario, Santiago de Compostela, Spain. Servei de Digestiu, Hospital General de Castelló, Spain. Servicio de Patología Digestiva, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Servicio de Medicina Digestiva, Hospital Reina Sofía, Córdoba, Spain. Hospital Costa del Sol, Marbella, Spain. Division of Gastroenterology, Montreal General Hospital Site, The Mc Gill University Health Centre, Quebec, Canada.
DOI
Quote
Gallach M, Calvet X, Lanas A, Feu F, Ponce J, Gisbert JP, et al. Clinical practice guidelines for managing nonvariceal upper gastrointestinal bleeding. Emergencias. 2013;25:472-81
Summary
Nonvariceal upper gastrointestinal (GI) bleeding is a common medical emergency
associated with appreciable morbidity and mortality. The significant advances made in
managing this condition in recent years have reduced the rates of rebleeding and
mortality. These clinical guidelines for managing this emergency are intended to be
highly practical, evidence-based, and take recent consensus statements into account.
The 3 keys to managing nonvariceal upper GI bleeding are a) early restoration of fluids
and blood pressure and the prevention of underlying cardiovascular disease, which is
common in these patients; b) endoscopy to treat lesions at high risk of rebleeding; and
c) medical therapy with high doses of proton pump inhibitors before and after
endoscopy. These 3 measures, used in combination, reduce upper GI rebleeding and
mortality rates.