Acute Non-Variceal Upper GI Bleeding
Pre-Endoscopy Management:
 • Hemodynamic resuscitation
 • No routine NG tube
 • Risk stratification using the Glasgow Blatchford scale
 • Pre-endoscopy IV PPI?
 • Restrictive blood transfusion policy
 • Anti-thrombotic management — anti-platelet agents, anti-coagulants
 • Promotility agents - IV erythromycin ?
 • 'Early endoscopy' within 24 hours
Post-Endoscopy Management:
 • High dose IV PPI x 72 hours
 • Initiate clear liquids
 • If peptic ulcer bleeding, test and treat H. Pylori
 • Anti-thrombotic management
 • Rescope if bleed with/without hemostasis
 • Transcatheter angiographic embolization if endoscopy fails
 • Surgery rarely needed today

Dr. Enrik Aguila @enrrikke

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