Gastrointestinal bleeding

Introduction

Gastrointestinal bleeding is the most prevalent indication for performing unscheduled diagnostic, and if needed, therapeutic endoscopy. For decades, therapeutic endoscopy in these circumstances has decreased mortality and the need for surgery. Nowadays however, even in cases of effective hemostasis, the prognosis for patients is driven more by co-morbidities. Epidemiology, etiology, pathophysiology, and treatment of gastrointestinal bleeding have dramatically changed over the past decades, leaving many questions open, particularly regarding the multidisciplinary and transversal management of these patients. At this year’s Digestive Disease Week (DDW 2010, 1 – 5 May, New Orleans, Louisiana, USA), abstracts on gastrointestinal bleeding made up 9 % of the accepted abstracts (478/5232), underscoring the importance of this subject in routine practice. Here we discuss those abstracts that focused on human cases of gastrointestinal bleeding with important expected clinical impact.

References

• 1 Jairath V, Logan R, Hearnshaw S. et al . Mortality from acute upper gastro-intestinal bleeding in the UK – does it display a “Weekend Effect”?.  Gastroenterology. 2010;  138 (Suppl. 1) S21
• 2 Tsoi K K, Pang S H, Chiu P W. et al . The risk of ulcer-related death in relation to hospital admission on public holidays: a cohort study on 10,428 cases of upper gastrointestinal bleeding in Hong Kong.  Gastrointest Endosc. 2010;  71 AB141
• 3 Dinani A, Nguyen G C. Outcomes of pregnant women hospitalized for non-variceal upper gastointestinal bleeding.  Gastroenterology. 2010;  138 (Suppl. 1) S89
• 4 Gralnek I M, Eisen G M, Holub J L. Lower gastrointestinal (GI) bleeding: an age-stratified comparison utilizing a large consortium of endoscopy practices.  Gastrointest Endosc. 2010;  71 AB246
• 5 Kuipers E J, Hill C, Veldhuyzen van Zanten S. Low-dose acetylsalicylic acid use and the risk of upper gastrointestinal bleeding: a systematic literature analysis.  Gastroenterology. 2010;  138 (Suppl. 1) S89
• 6 Garcia R odriguez, Lin K, Hernandez-Diaz S. et al . Low-dose acetylsalicylic acid in combination with clopidogrel, warfarin, non-steroidal anti-inflammatory drugs or steroids: risk of upper gastrointestinal bleeding.  Gastroenterology. 2010;  138 (Suppl. 1) S89
• 7 Strate L L, Liu Y, Huang E S. et al . Aspirin and nonsteroidal anti-inflammatory drugs and the risk of diverticular complications.  Gastroenterology. 2010;  138 (Suppl. 1) S630
• 8 Cuschieri J R, Drawz P, Falck-Ytter Y. et al . Risk factors for acute GI bleeding following myocardial infarction in patients who are prescribed clopidogrel.  Gastroenterology. 2010;  138 (Suppl. 1) S20
• 9 Toyokawa T, Inaba T, Ishikawa S. et al . The investigation of upper gastrointestinal bleeding after implantation of drug-eluting stents: prospective cohort study.  Gastrointest Endosc. 2010;  71 AB360
• 10 Lin K, Hernandez-Diaz S, Garcia Rodriguez L A. Effect of anti-secretory medicines and nitrates on the risk of ulcer bleeding among users of clopidogrel, low-dose acetylsalicylic acid, corticosteroids, non-steroidal anti-inflammatory drugs, and oral anticoagulants.  Gastroenterology. 2010;  138 (Suppl. 1) S90
• 11 Van Boxel O S, Van Oijen M G, Hagenaars M P. et al . New clopidogrel users on PPIs are at an increased risk of cardiovascular and gastrointestinal complications – results of a large Dutch cohort study.  Gastroenterology. 2010;  138 (Suppl. 1) S19
• 12 Chan F K, Scheiman J M, Lanas A. et al . Celecoxib versus diclofenac and omeprazole: a randomized controlled trial comparing a composite outcome across the entire GI tract (The Condor Trial).  Gastroenterology. 2010;  138 (Suppl. 1) S20
• 13 Vikneswaran N, Lutzke L S, Prasad G A. et al . Bleeding and thrombotic risk in endoscopic mucosal resection (EMR) with clopidogrel.  Gastrointest Endosc. 2010;  71 AB126
• 14 Grossman E B, Maranino A N, Zamora D C. et al . Antiplatelet medications increase the risk of post-polypectomy bleeding.  Gastrointest Endosc. 2010;  71 AB138
• 15 Stanley A J, Ashley D, Dalton H R. et al . Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation.  Lancet. 2009;  373 42-47
• 16 Stanley A J, Dalton H R, Blatchford O. Multicentre comparison of the Glasgow Blatchford and Rockall Scores in the prediction of clinical end-points in upper GI haemorrhage.  Gastrointest Endosc. 2010;  71 AB147
• 17 Lim L, Ho K Y, Chan H Y. et al . Glasgow Blatchford Score as an effective triage tool for identifying patients with severe upper gastrointestinal bleeding with high mortality risk.  Gastroenterology. 2010;  138 (Suppl. 1) S178
• 18 Laine L A, Shah A. Randomized trial of urgent vs. elective colonoscopy in patients hospitalized with lower GI bleeding.  Gastrointest Endosc. 2010;  71 AB112
• 19 Szary N M, Choudhary A, Matteson M L. et al . Erythromycin prior to endoscopy in acute upper gastrointestinal bleeding: a meta analysis.  Gastroenterology. 2010;  138 (Suppl. 1) S20
• 20 Jensen D M, Ahlbom H, Eklund S. et al . Rebleeding risk for oozing peptic ulcer bleeding (PUB) in a large international study – a reassessment based upon a multivariate analysis.  Gastrointest Endosc. 2010;  71 AB117
• 21 Sung J J, Luo D, Wu J C. et al . Nanopowders are highly effective in achieving hemostasis in severe peptic ulcer bleeding: an interim report of a prospective human trial.  Gastrointest Endosc. 2010;  71 AB198
• 22 Wong T C, Chiu P W, Wong K T. et al . A comparison of transcatheter arterial embolization to surgery after failed endoscopic hemostasis to bleeding peptic ulcers.  Gastrointest Endosc. 2010;  71 AB113