Khayyat YM. Trends in upper gastrointestinal bleeding management. World J Clin Cases 2024; 12(27): 6007-6010 [PMID: 39328864 DOI: 10.12998/wjcc.v12.i27.6007]
Corresponding Author of This Article
Yasir M Khayyat, FACG, FACP, FRCP (C), Professor, Department of Medicine, Faculty of Medicine, Umm AL-Qura University, AlAwali District, Makkah 8156-24381, Saudi Arabia. ymkhayyat@uqu.edu.sa
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 26, 2024; 12(27): 6007-6010 Published online Sep 26, 2024. doi: 10.12998/wjcc.v12.i27.6007
Trends in upper gastrointestinal bleeding management
Yasir M Khayyat
Yasir M Khayyat, Department of Medicine, Faculty of Medicine, Umm AL-Qura University, Makkah 8156-24381, Saudi Arabia
Author contributions: Khayyat YM contributed to conceptualization, drafting, and revision of the editorial manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yasir M Khayyat, FACG, FACP, FRCP (C), Professor, Department of Medicine, Faculty of Medicine, Umm AL-Qura University, AlAwali District, Makkah 8156-24381, Saudi Arabia. ymkhayyat@uqu.edu.sa
Received: March 6, 2024 Revised: June 15, 2024 Accepted: June 26, 2024 Published online: September 26, 2024 Processing time: 146 Days and 9.7 Hours
Abstract
Upper gastrointestinal bleeding (UGIB) can be attributed to either non-variceal or variceal causes. The latter is more aggressive with hemodynamic instability secondary to decompensated cirrhosis and portal hypertension. Non-variceal UGIB (NVUGIB) occurs due to impaired gastroprotective mechanisms attributed to several drugs such as anticoagulants and nonsteroidal anti-inflammatory drugs. Helicobacter pylori infection contributes to the development of peptic ulcer bleeding as well. NVUGIB presentation can be either hemodynamically stable or unstable. During the initial assessment a scoring system including patient-related factors (current cardiac, renal, and liver diseases and hemodynamic and laboratory parameters) is used to determine the patient’s prognosis. The Glasgow Blatchford score has been shown to be the most useful and precise. Those with high-risk NVUGIB require urgent assessment and upper endoscopy to achieve better short-term and long-term outcomes such as less hospitalization, blood transfusion, and surgery.
Core Tip: Non-variceal upper gastrointestinal bleeding (NVUGIB) is a medical emergency that requires assessment of patient factors, hemodynamic parameters, and laboratory work to determine the patient’s prognosis and treatment. Patients with low-risk NVUGIB are typically discharged quickly, while patients with high-risk NVUGIB may require administration of volume replacement, blood transfusion, and high-dose intravenous proton pump inhibitors. These high-risk patients also require urgent upper endoscopy. Evaluation of the need for anticoagulant and analgesics after discharge is also needed.
