title: Upper gastrointestinal tract bleeding. Predisposing factors, diagnosis, and therapy.
abstract: The mortality from upper gastrointestinal (GI) tract bleeding has remained constant at 10% during the past 40 years. Many drugs may precipitate upper GI tract bleeding by disrupting the gastric mucosal barrier. Aspirin-induced injury to the gastric mucosa and GI tract bleeding have been documented in many studies; some of the mechanisms involved are known, but others are still being investigated. An approach to the bleeding patient is suggested; initial resuscitation, history taking, physical examination, determination of bleeding levels, and diagnostic procedures to determine the cause of bleeding are reviewed. Also described are available therapies for GI tract bleeding-gastric lavage, drug therapy, endoscopic control, electrocautery, thermal probe, tissue adhesive, and laser photocoagulation. The merits of the argon laser and the neodymium-yttrium aluminum garnet laser (both still in experimental stages) are described and compared. No pharmacologic or endoscopic therapies for upper GI tract bleeding have been proved effective.
mesh_terms: D000792:Angiography; D001241:Aspirin / Q000009:adverse effects; D004064:Digestive System / Q000000981:diagnostic imaging; D004564:Electrocoagulation; D004724:Endoscopy; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy*; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D053685:Laser Therapy; D010437:Peptic Ulcer / Q000150:complications; D014014:Tissue Adhesives / Q000627:therapeutic use
chemical_list: D014014:Tissue Adhesives; D001241:Aspirin