title: Nonvariceal Upper Gastrointestinal Bleeding: Timing of Endoscopy and Ways to Improve Endoscopic Visualization.
abstract: Upper gastrointestinal (UGI) endoscopy is the cornerstone of diagnosis and management of patients presenting with acute UGI bleeding. Once hemodynamically resuscitated, early endoscopy (performed within 24 hours of patient presentation) ensures accurate identification of the bleeding source, facilitates risk stratification based on endoscopic stigmata, and allows endotherapy to be delivered where indicated. Moreover, the preendoscopy use of a prokinetic agent (eg, i.v. erythromycin), especially in patients with a suspected high probability of having blood or clots in the stomach before undergoing endoscopy, may result in improved endoscopic visualization, a higher diagnostic yield, and less need for repeat endoscopy.
authors.affiliation: Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Israel; Interventional Endoscopy Unit, Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Iyad
authors.initials: I
authors.lastname: Khamaysi
authors.affiliation: Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Israel; The Institute of Gastroenterology and Liver Diseases, Ha'Emek Medical Center, Afula, Israel. Electronic address: ian_gr@clalit.org.il.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Gralnek
mesh_terms: D000208:Acute Disease; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D013997:Time Factors
keywords: Endoscopy; Peptic ulcer bleeding; Prokinetic agent; Upper gastrointestinal bleeding