title: Advances in gastrointestinal bleeding.
abstract: The main innovations of the latest meeting of the Gastroenterological Association (2016) concerning upper gastrointestinal bleeding from the clinician's perspective can be summarised as follows: a) The Glasgow-Blatchford scale has the best accuracy in predicting the need for surgical intervention and hospital mortality; b) Prognostic scales for non-variceal upper gastrointestinal bleeding are also useful for lower gastrointestinal bleeding; c) Preliminary data suggest that treatment with hemospray does not seem to be superior to current standard treatment in controlling active peptic ulcer bleeding; d) Either famotidine or a proton pump inhibitor may be effective in preventing haemorrhagic recurrence in patients taking aspirin, but this finding needs to be confirmed in further studies; e) There was confirmation of the need to re-introduce antiplatelet therapy as early as possible in patients with antiplatelet-associated gastrointestinal bleeding in order to prevent cardiovascular mortality; f) Routine clinical practice suggests that gastrointestinal or cardiovascular complications with celecoxib or traditional NSAIDs are very low; g) Dabigatran is associated with an increased incidence of gastrointestinal bleeding compared with apixaban or warfarin. At least half of the episodes are located in the lower gastrointestinal tract; h) Implant devices for external ventricular circulatory support are associated with early gastrointestinal bleeding in up to one third of patients; the bleeding is often secondary to arteriovenous malformations.
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: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy; D006801:Humans; D010437:Peptic Ulcer; D010438:Peptic Ulcer Hemorrhage; D054328:Proton Pump Inhibitors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors; D001241:Aspirin
keywords: Anticoagulantes; Anticoagulants; Antiinflamatorios no esteroideos; Aspirin; Gastrointestinal bleeding; Hemorragia gastrointestinal; Inhibidor de la bomba de protons; Non-steroidal anti-inflammatory drugs; Peptic ulcer; Proton pump inhibitor; Ácido acetilsalicílico; Úlcera péptica