Abstract
Background Gastrointestinal bleeding (GIB) represents a significant cause of morbidity and mortality.
The primary diagnostic and therapeutic tool is endoscopy. New devices are being developed
and employed that facilitate the management of this pathology. In this review, we
show the status of endoscopic management of digestive hemorrhage, current practices,
and future directions.
Methods We explore the management of patients with GIB (upper and lower). Besides, we analyzed
the diagnostic methods in occult digestive hemorrhage. We show the evidence collected
so far, and how each therapeutic method can be applied.
Results GIB constitutes a challenge for the attending physician. Different therapeutic procedures
are available. Less invasive devices have a role in the diagnosis but not therapy.
The use of risk stratification is well established for upper bleeding, but for lower
bleeding, there is still no evidence to support the use of these scores. Knowledge
of altered anatomy is crucial in special populations.
Conclusion A variety of procedures are available for the treatment of GIB. Emphasis should be
placed on less invasive diagnostic techniques as well as on new and more efficient
therapies. Attention should be given to the initial management, with timely diagnosis
and effective resuscitation to decrease the morbidity and mortality.
Keywords
gastrointestinal bleeding - endoscopy - endoscopic therapy - endoscopic hemostasis
