title: [Gastrointestinal bleeding].
abstract: In the Digestive Disease Week in 2015 there have been some new contributions in the field of gastrointestinal bleeding that deserve to be highlighted. Treatment of celecoxib with a proton pump inhibitor is safer than treatment with nonselective NSAID and a proton pump inhibitor in high risk gastrointestinal and cardiovascular patients who mostly also take acetylsalicylic acid. Several studies confirm the need to restart the antiplatelet or anticoagulant therapy at an early stage after a gastrointestinal hemorrhage. The need for urgent endoscopy before 6-12 h after the onset of upper gastrointestinal bleeding episode may be beneficial in patients with hemodynamic instability and high risk for comorbidity. It is confirmed that in Western but not in Japanese populations, gastrointestinal bleeding episodes admitted to hospital during weekend days are associated with a worse prognosis associated with delays in the clinical management of the events. The strategy of a restrictive policy on blood transfusions during an upper GI bleeding event has been challenged. Several studies have shown the benefit of identifying the bleeding vessel in non varicose underlying gastric lesions by Doppler ultrasound which allows direct endoscopic therapy in the patient with upper GI bleeding. Finally, it has been reported that lower gastrointestinal bleeding diverticula band ligation or hemoclipping are both safe and have the same long-term outcomes.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Universidad de Zaragoza, IIS Aragón, CIBERehd, Zaragoza, España. Electronic address: alanas@unizar.es.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Lanas
mesh_terms: D000740:Anemia / Q000209:etiology / Q000628:therapy; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use; D001803:Blood Transfusion; D000068579:Celecoxib / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D016099:Endoscopy, Gastrointestinal; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy; D006474:Hemorrhagic Disorders / Q000139:chemically induced; D006489:Hemostatic Techniques; D006801:Humans; D008026:Ligation; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D019851:Thrombophilia / Q000188:drug therapy
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors; D000068579:Celecoxib; D001241:Aspirin
keywords: Anticoagulantes; Anticoagulants; Antiinflamatorios no esteroideos; Aspirin; Doppler; Gastrointestinal bleeding; Hemorragia gastrointestinal; Nonsteroidal antinflammatory drugs; Tratamiento endoscópico; Ácido acetilsalicílico; Úlcera péptica