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Upper gastrointestinal bleeding

MedGen UID:
52926
•Concept ID:
C0041909
•
Pathologic Function
Synonym: Upper gastrointestinal hemorrhage
SNOMED CT: Upper GI - gastrointestinal hemorrhage (37372002); Upper gastrointestinal hemorrhage (37372002); Upper gastrointestinal bleeding (37372002); Upper GI hemorrhage (37372002); Upper GI bleeding (37372002)

Definition

Bleeding originating from the upper gastrointestinal tract (oral cavity, pharynx, esophagus, and stomach). [from NCI]

Professional guidelines

PubMed

ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding.
Laine L, Barkun AN, Saltzman JR, Martel M, Leontiadis GI
Am J Gastroenterol 2021 May 1;116(5):899-917. doi: 10.14309/ajg.0000000000001245. PMID: 33929377
Upper Gastrointestinal Bleeding in Adults: Evaluation and Management.
Wilkins T, Wheeler B, Carpenter M
Am Fam Physician 2020 Mar 1;101(5):294-300. PMID: 32109037
Management of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group.
Barkun AN, Almadi M, Kuipers EJ, Laine L, Sung J, Tse F, Leontiadis GI, Abraham NS, Calvet X, Chan FKL, Douketis J, Enns R, Gralnek IM, Jairath V, Jensen D, Lau J, Lip GYH, Loffroy R, Maluf-Filho F, Meltzer AC, Reddy N, Saltzman JR, Marshall JK, Bardou M
Ann Intern Med 2019 Dec 3;171(11):805-822. Epub 2019 Oct 22 doi: 10.7326/M19-1795. PMID: 31634917Free PMC Article

Recent clinical studies

Etiology

Emergency medicine updates: Upper gastrointestinal bleeding.
Long B, Gottlieb M
Am J Emerg Med 2024 Jul;81:116-123. Epub 2024 May 3 doi: 10.1016/j.ajem.2024.04.052. PMID: 38723362
Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding.
Lau JYW, Yu Y, Tang RSY, Chan HCH, Yip HC, Chan SM, Luk SWY, Wong SH, Lau LHS, Lui RN, Chan TT, Mak JWY, Chan FKL, Sung JJY
N Engl J Med 2020 Apr 2;382(14):1299-1308. doi: 10.1056/NEJMoa1912484. PMID: 32242355
Upper Gastrointestinal Bleeding: Etiologies and Management.
Kamboj AK, Hoversten P, Leggett CL
Mayo Clin Proc 2019 Apr;94(4):697-703. doi: 10.1016/j.mayocp.2019.01.022. PMID: 30947833
Evaluation and management of Non-variceal upper gastrointestinal bleeding.
Samuel R, Bilal M, Tayyem O, Guturu P
Dis Mon 2018 Jul;64(7):333-343. Epub 2018 Mar 7 doi: 10.1016/j.disamonth.2018.02.003. PMID: 29525375
Epidemiology and Risk Factors for Upper Gastrointestinal Bleeding.
Tielleman T, Bujanda D, Cryer B
Gastrointest Endosc Clin N Am 2015 Jul;25(3):415-28. doi: 10.1016/j.giec.2015.02.010. PMID: 26142028

Diagnosis

Emergency medicine updates: Upper gastrointestinal bleeding.
Long B, Gottlieb M
Am J Emerg Med 2024 Jul;81:116-123. Epub 2024 May 3 doi: 10.1016/j.ajem.2024.04.052. PMID: 38723362
Gastrointestinal Bleeding in Children: Current Management, Controversies, and Advances.
Novak I, Bass LM
Gastrointest Endosc Clin N Am 2023 Apr;33(2):401-421. doi: 10.1016/j.giec.2022.11.003. PMID: 36948753
Upper Gastrointestinal Bleeding: Etiologies and Management.
Kamboj AK, Hoversten P, Leggett CL
Mayo Clin Proc 2019 Apr;94(4):697-703. doi: 10.1016/j.mayocp.2019.01.022. PMID: 30947833
Evaluation and management of Non-variceal upper gastrointestinal bleeding.
Samuel R, Bilal M, Tayyem O, Guturu P
Dis Mon 2018 Jul;64(7):333-343. Epub 2018 Mar 7 doi: 10.1016/j.disamonth.2018.02.003. PMID: 29525375
Acute upper gastrointestinal bleeding (UGIB) - initial evaluation and management.
Khamaysi I, Gralnek IM
Best Pract Res Clin Gastroenterol 2013 Oct;27(5):633-8. Epub 2013 Sep 25 doi: 10.1016/j.bpg.2013.09.002. PMID: 24160923

Therapy

Gastrointestinal Bleeding in Children: Current Management, Controversies, and Advances.
Novak I, Bass LM
Gastrointest Endosc Clin N Am 2023 Apr;33(2):401-421. doi: 10.1016/j.giec.2022.11.003. PMID: 36948753
AGA Clinical Practice Update on De-Prescribing of Proton Pump Inhibitors: Expert Review.
Targownik LE, Fisher DA, Saini SD
Gastroenterology 2022 Apr;162(4):1334-1342. Epub 2022 Feb 17 doi: 10.1053/j.gastro.2021.12.247. PMID: 35183361
Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding.
Lau JYW, Yu Y, Tang RSY, Chan HCH, Yip HC, Chan SM, Luk SWY, Wong SH, Lau LHS, Lui RN, Chan TT, Mak JWY, Chan FKL, Sung JJY
N Engl J Med 2020 Apr 2;382(14):1299-1308. doi: 10.1056/NEJMoa1912484. PMID: 32242355
Evaluation and management of Non-variceal upper gastrointestinal bleeding.
Samuel R, Bilal M, Tayyem O, Guturu P
Dis Mon 2018 Jul;64(7):333-343. Epub 2018 Mar 7 doi: 10.1016/j.disamonth.2018.02.003. PMID: 29525375
Transfusion strategies for acute upper gastrointestinal bleeding.
Villanueva C, Colomo A, Bosch A, Concepción M, Hernandez-Gea V, Aracil C, Graupera I, Poca M, Alvarez-Urturi C, Gordillo J, Guarner-Argente C, Santaló M, Muñiz E, Guarner C
N Engl J Med 2013 Jan 3;368(1):11-21. doi: 10.1056/NEJMoa1211801. PMID: 23281973

Prognosis

Effect of Stress Ulcer Prophylaxis With Proton Pump Inhibitors vs Histamine-2 Receptor Blockers on In-Hospital Mortality Among ICU Patients Receiving Invasive Mechanical Ventilation: The PEPTIC Randomized Clinical Trial.
PEPTIC Investigators for the Australian and New Zealand Intensive Care Society Clinical Trials Group, Alberta Health Services Critical Care Strategic Clinical Network, and the Irish Critical Care Trials Group, Young PJ, Bagshaw SM, Forbes AB, Nichol AD, Wright SE, Bailey M, Bellomo R, Beasley R, Brickell K, Eastwood GM, Gattas DJ, van Haren F, Litton E, Mackle DM, McArthur CJ, McGuinness SP, Mouncey PR, Navarra L, Opgenorth D, Pilcher D, Saxena MK, Webb SA, Wiley D, Rowan KM
JAMA 2020 Feb 18;323(7):616-626. doi: 10.1001/jama.2019.22190. PMID: 31950977Free PMC Article
Changing epidemiology and etiology of upper and lower gastrointestinal bleeding.
Oakland K
Best Pract Res Clin Gastroenterol 2019 Oct-Dec;42-43:101610. Epub 2019 Apr 17 doi: 10.1016/j.bpg.2019.04.003. PMID: 31785737
Prophylaxis against Upper Gastrointestinal Bleeding in Hospitalized Patients.
Cook D, Guyatt G
N Engl J Med 2018 Jun 28;378(26):2506-2516. doi: 10.1056/NEJMra1605507. PMID: 29949497
Initial Assessment and Resuscitation in Nonvariceal Upper Gastrointestinal Bleeding.
Simon TG, Travis AC, Saltzman JR
Gastrointest Endosc Clin N Am 2015 Jul;25(3):429-42. Epub 2015 Apr 18 doi: 10.1016/j.giec.2015.02.006. PMID: 26142029
Epidemiology and Risk Factors for Upper Gastrointestinal Bleeding.
Tielleman T, Bujanda D, Cryer B
Gastrointest Endosc Clin N Am 2015 Jul;25(3):415-28. doi: 10.1016/j.giec.2015.02.010. PMID: 26142028

Clinical prediction guides

Emergency medicine updates: Upper gastrointestinal bleeding.
Long B, Gottlieb M
Am J Emerg Med 2024 Jul;81:116-123. Epub 2024 May 3 doi: 10.1016/j.ajem.2024.04.052. PMID: 38723362
ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding.
Laine L, Barkun AN, Saltzman JR, Martel M, Leontiadis GI
Am J Gastroenterol 2021 May 1;116(5):899-917. doi: 10.14309/ajg.0000000000001245. PMID: 33929377
Treatment of upper gastrointestinal bleeding in 2020: New techniques and outcomes.
Lau LHS, Sung JJY
Dig Endosc 2021 Jan;33(1):83-94. Epub 2020 May 20 doi: 10.1111/den.13674. PMID: 32216134
Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding.
Lau JYW, Yu Y, Tang RSY, Chan HCH, Yip HC, Chan SM, Luk SWY, Wong SH, Lau LHS, Lui RN, Chan TT, Mak JWY, Chan FKL, Sung JJY
N Engl J Med 2020 Apr 2;382(14):1299-1308. doi: 10.1056/NEJMoa1912484. PMID: 32242355
A risk score to predict need for treatment for upper-gastrointestinal haemorrhage.
Blatchford O, Murray WR, Blatchford M
Lancet 2000 Oct 14;356(9238):1318-21. doi: 10.1016/S0140-6736(00)02816-6. PMID: 11073021

Recent systematic reviews

Proton-Pump Inhibitors to Prevent Gastrointestinal Bleeding - An Updated Meta-Analysis.
Wang Y, Parpia S, Ge L, Heels-Ansdell D, Lai H, Esfahani MA, Pan B, Alhazzani W, Schandelmaier S, Lauzier F, Arabi Y, Barletta J, Deane A, Finfer S, Williamson D, Kanji S, Møller MH, Perner A, Krag M, Young PJ, Dionne JC, Hammond N, Ye Z, Ibrahim Q, Cook D
NEJM Evid 2024 Jul;3(7):EVIDoa2400134. Epub 2024 Jun 14 doi: 10.1056/EVIDoa2400134. PMID: 38874580
Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding.
Kanno T, Yuan Y, Tse F, Howden CW, Moayyedi P, Leontiadis GI
Cochrane Database Syst Rev 2022 Jan 7;1(1):CD005415. doi: 10.1002/14651858.CD005415.pub4. PMID: 34995368Free PMC Article
Tranexamic acid for gastrointestinal bleeding: A systematic review with meta-analysis of randomized clinical trials.
Lee PL, Yang KS, Tsai HW, Hou SK, Kang YN, Chang CC
Am J Emerg Med 2021 Jul;45:269-279. Epub 2020 Aug 29 doi: 10.1016/j.ajem.2020.08.062. PMID: 33041136
Management of acute upper gastrointestinal bleeding.
Stanley AJ, Laine L
BMJ 2019 Mar 25;364:l536. doi: 10.1136/bmj.l536. PMID: 30910853
Restrictive versus liberal blood transfusion for gastrointestinal bleeding: a systematic review and meta-analysis of randomised controlled trials.
Odutayo A, Desborough MJ, Trivella M, Stanley AJ, Dorée C, Collins GS, Hopewell S, Brunskill SJ, Kahan BC, Logan RF, Barkun AN, Murphy MF, Jairath V
Lancet Gastroenterol Hepatol 2017 May;2(5):354-360. Epub 2017 Mar 23 doi: 10.1016/S2468-1253(17)30054-7. PMID: 28397699

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