title: Role of Medical Therapy for Nonvariceal Upper Gastrointestinal Bleeding.
abstract: Nonvariceal upper gastrointestinal bleeding (UGIB) is a major cause of morbidity and mortality worldwide. Mortality from UGIB has remained 5-10% over the past decade. This article presents current evidence-based recommendations for the medical management of UGIB. Preendoscopic management includes initial resuscitation, risk stratification, appropriate use of blood products, and consideration of nasogastric tube insertion, erythromycin, and proton pump inhibitor therapy. The use of postendoscopic intravenous proton pump inhibitors is strongly recommended for certain patient populations. Postendoscopic management also includes the diagnosis and treatment of Helicobacter pylori, appropriate use of proton pump inhibitors and iron replacement therapy.
authors.affiliation: Department of Medicine, Toronto General Hospital, University of Toronto, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada.
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Fortinsky
authors.affiliation: Gastroenterology Department & Centre d'Investigations Clinique CIC1432, CHU de Dijon, 14 rue Gaffarel BP77908, Dijon, Cedex 21079, France. Electronic address: marc.bardou@u-bourgogne.fr.
authors.forename: Marc
authors.initials: M
authors.lastname: Bardou
authors.affiliation: Gastroenterology Department, McGill University Health Centre, Montreal General Hospital Site, Room D7-346, 1650 Cedar Avenue, Montréal, Québec H3G 1A4, Canada.
authors.forename: Alan N
authors.initials: AN
authors.lastname: Barkun
mesh_terms: D019468:Disease Management; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy*; D006801:Humans
chemical_list: D005765:Gastrointestinal Agents
keywords: Erythromycin; Iron replacement therapy; Nasogastric lavage; Nonvariceal upper gastrointestinal bleeding; Proton pump inhibitors; Red blood cell transfusions; Tranexamic acid