Acute Upper and Lower Gastrointestinal Bleeding Reference Library Rabbit Hole: Acute Upper and Lower Gastrointestinal Bleeding

Lesson 2 of2

In Progress

Rabbit Hole: Acute Upper and Lower Gastrointestinal Bleeding

Riszel October 28, 2021

Guidelines

Laine, Loren MD, FACG1,2; Barkun, Alan N. MD, FACG3; Saltzman, John R. MD, FACG4; Martel, Myriam MSc2; Leontiadis, Grigorios I. MD, PhD5 ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding, The American Journal of Gastroenterology: May 2021 – Volume 116 – Issue 5 – p 899-917.doi: 10.14309/ajg.0000000000001245

Strate, Lisa L MD, MPH, FACG1; Gralnek, Ian M MD, MSHS2 ACG Clinical Guideline: Management of Patients With Acute Lower Gastrointestinal Bleeding, American Journal of Gastroenterology: April 2016 – Volume 111 – Issue 4 – p 459-474 doi: 10.1038/ajg.2016.41

Kim JS, Kim BW, Kim DH, et al. Guidelines for Nonvariceal Upper Gastrointestinal Bleeding. Gut Liver. 2020;14(5):560-570. doi:10.5009/gnl20154

Endoscopic diagnosis and management of nonvariceal uppergastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021 by Ian M. Gralnek, Adrian J. Stanley, A. John Morris, Marine Camus, James Lau, Angel Lanas, Stig B. Laursen , Franco Radaelli, Ioannis S. Papanikolaou, Tiago Cúrdia Gonçalves, Mario Dinis-Ribeiro, Halim Awadie , Georg Braun, Nicolette de Groot, Marianne Udd, Andres Sanchez-Yague,Ziv Neeman,Jeanin E. van Hooft

ASHP : Gastrointestinal Bleeding. Planned by the American Society of Health-System Pharmacists. 2019

Barkun AN, Almadi M, Kuipers EJ, Laine L, Sung J, Tse F, Leontiadis GI, Abraham NS, Calvet X, Chan FKL, Douketis J, Enns R, Gralnek IM, Jairath V, Jensen D, Lau J, Lip GYH, Loffroy R, Maluf-Filho F, Meltzer AC, Reddy N, Saltzman JR, Marshall JK, Bardou M. Management of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group. Ann Intern Med. 2019 Dec 3;171(11):805-822. doi: 10.7326/M19-1795. Epub 2019 Oct 22. PMID: 31634917; PMCID: PMC7233308.

Management

Aoki T, Hirata Y, Yamada A, Koike K. Initial management for acute lower gastrointestinal bleeding. World J Gastroenterol. 2019;25(1):69-84. doi:10.3748/wjg.v25.i1.69

Osman, D., Djibré, M., Da Silva, D. et al. Management by the intensivist of gastrointestinal bleeding in adults and children. Ann. Intensive Care 2, 46 (2012). https://doi.org/10.1186/2110-5820-2-46

Cremers I, Ribeiro S. Management of variceal and nonvariceal upper gastrointestinal bleeding in patients with cirrhosis. Therap Adv Gastroenterol. 2014;7(5):206-216.doi:10.1177/1756283X14538688
Kawaguchi, K., Kurumi, H., Takeda, Y., Yashima, K., & Isomoto, H. (2017). Management for non-variceal upper gastrointestinal bleeding in elderly patients: the experience of a tertiary university hospital. Annals Of Translational Medicine, 5(8), 2. doi:10.21037/atm.2017.03.103

Primary Literature

Proton Pump Inhibitors

Andrews CN, Levy A, Fishman M, Hahn M, Atkinson K, Kwan P, Enns R. Intravenous proton pump inhibitors before endoscopy in bleeding peptic ulcer with high-risk stigmata: a multicentre comparative study. Can J Gastroenterol. 2005 Nov;19(11):667-71. doi: 10.1155/2005/476205. PMID: 16292361.

Solana MJ, López-Herce J, Sánchez A, Sánchez C, Urbano J, López D, Carrillo A. 0.5 mg/kg versus 1 mg/kg of intravenous omeprazole for the prophylaxis of gastrointestinal bleeding in critically ill children: a randomized study. J Pediatr. 2013 Apr;162(4):776-782.e1. doi: 10.1016/j.jpeds.2012.10.010. Epub 2012 Nov 10. PMID: 23149178.

Chwiesko A, Charkiewicz R, Niklinski J, Luczaj W, Skrzydlewska E, Milewski R, Baniukiewicz A, Wroblewski E, Rosolowski M, Dabrowski A. Effects of different omeprazole dosing on gastric pH in non-variceal upper gastrointestinal bleeding: A randomized prospective study. J Dig Dis. 2016 Sep;17(9):588-599. doi: 10.1111/1751-2980.12393. PMID: 27518195.

Lou W, Xia Y, Xiang P, Zhang L, Yu X, Lim S, Xu M, Zhao L, Rydholm H, Traxler B, Qin X. Prevention of upper gastrointestinal bleeding in critically ill Chinese patients: a randomized, double-blind study evaluating esomeprazole and cimetidine. Curr Med Res Opin. 2018 Aug;34(8):1449-1455. doi: 10.1080/03007995.2018.1464132. Epub 2018 Apr 20. PMID: 29638148.

Belei O, Olariu L, Puiu M, Jinca C, Dehelean C, Marcovici T, Marginean O. Continuous esomeprazole infusion versus bolus administration and second look endoscopy for the prevention of rebleeding in children with a peptic ulcer. Rev Esp Enferm Dig. 2018 Jun;110(6):352-357. doi: 10.17235/reed.2018.4864/2017. PMID: 29465250.

Sung JJ, Suen BY, Wu JC, Lau JY, Ching JY, Lee VW, Chiu PW, Tsoi KK, Chan FK. Effects of intravenous and oral esomeprazole in the prevention of recurrent bleeding from peptic ulcers after endoscopic therapy. Am J Gastroenterol. 2014 Jul;109(7):1005-10. doi: 10.1038/ajg.2014.105. Epub 2014 Apr 29. PMID: 24777150.

Chiu PW, Joeng HK, Choi CL, Tsoi KK, Kwong KH, Lam SH, Sung JJ. High-dose omeprazole infusion compared with scheduled second-look endoscopy for prevention of peptic ulcer rebleeding: a randomized controlled trial. Endoscopy. 2016 Aug;48(8):717-22. doi: 10.1055/s-0042-107590. Epub 2016 Jun 8. PMID: 27275859.

Liu N, Liu L, Zhang H, Gyawali PC, Zhang D, Yao L, Yang Y, Wu K, Ding J, Fan D. Effect of intravenous proton pump inhibitor regimens and timing of endoscopy on clinical outcomes of peptic ulcer bleeding. J Gastroenterol Hepatol. 2012 Sep;27(9):1473-9. doi: 10.1111/j.1440-1746.2012.07191.x. PMID: 22646140.

Cui LH, Li C, Wang XH, Yan ZH, He X, Gong SD. The therapeutic effect of high-dose esomeprazole on stress ulcer bleeding in trauma patients. Chin J Traumatol. 2015;18(1):41-3. doi: 10.1016/j.cjtee.2014.06.001. PMID: 26169094.

Yen HH, Yang CW, Su WW, Soon MS, Wu SS, Lin HJ. Oral versus intravenous proton pump inhibitors in preventing re-bleeding for patients with peptic ulcer bleeding after successful endoscopic therapy. BMC Gastroenterol. 2012 Jun 8;12:66. doi: 10.1186/1471-230X-12-66. PMID: 22681960; PMCID: PMC3503825.

Bai Y, Chen DF, Wang RQ, Chen YX, Shi RH, Tian DA, Chen H, Eklund S, Li ZS; Chinese Peptic Ulcer Bleeding Research Group. Intravenous Esomeprazole for Prevention of Peptic Ulcer Rebleeding: A Randomized Trial in Chinese Patients. Adv Ther. 2015 Nov;32(11):1160-76. doi: 10.1007/s12325-015-0265-6. Epub 2015 Nov 18. PMID: 26581750.

Cheng HC, Wu CT, Chang WL, Cheng WC, Chen WY, Sheu BS. Double oral esomeprazole after a 3-day intravenous esomeprazole infusion reduces recurrent peptic ulcer bleeding in high-risk patients: a randomised controlled study. Gut. 2014 Dec;63(12):1864-72. doi: 10.1136/gutjnl-2013-306531. Epub 2014 Mar 21. PMID: 24658598.

Krag M, Marker S, Perner A, Wetterslev J, Wise MP, Schefold JC, Keus F, Guttormsen AB, Bendel S, Borthwick M, Lange T, Rasmussen BS, Siegemund M, Bundgaard H, Elkmann T, Jensen JV, Nielsen RD, Liboriussen L, Bestle MH, Elkjær JM, Palmqvist DF, Bäcklund M, Laake JH, Bådstøløkken PM, Grönlund J, Breum O, Walli A, Winding R, Iversen S, Jarnvig IL, White JO, Brand B, Madsen MB, Quist L, Thornberg KJ, Møller A, Wiis J, Granholm A, Anthon CT, Meyhoff TS, Hjortrup PB, Aagaard SR, Andreasen JB, Sørensen CA, Haure P, Hauge J, Hollinger A, Scheuzger J, Tuchscherer D, Vuilliomenet T, Takala J, Jakob SM, Vang ML, Pælestik KB, Andersen KLD, van der Horst ICC, Dieperink W, Fjølner J, Kjer CKW, Sølling C, Sølling CG, Karttunen J, Morgan MPG, Sjøbø B, Engstrøm J, Agerholm-Larsen B, Møller MH; SUP-ICU trial group. Pantoprazole in Patients at Risk for Gastrointestinal Bleeding in the ICU. N Engl J Med. 2018 Dec 6;379(23):2199-2208. doi: 10.1056/NEJMoa1714919. Epub 2018 Oct 24. PMID: 30354950.

Marker S, Krag M, Perner A, Wetterslev J, Lange T, Wise MP, Borthwick M, Bendel S, Keus F, Guttormsen AB, Schefold JC, Rasmussen BS, Elkmann T, Bestle M, Arenkiel B, Laake JH, Kamper MK, Lång M, Pawlowicz-Dworzanska MB, Karlsson S, Liisanantti J, Dey N, Knudsen H, Granholm A, Møller MH; SUP-ICU trial investigators. Pantoprazole in ICU patients at risk for gastrointestinal bleeding-1-year mortality in the SUP-ICU trial. Acta Anaesthesiol Scand. 2019 Oct;63(9):1184-1190. doi: 10.1111/aas.13436. Epub 2019 Jul 19. PMID: 31282567.

Yao DK, Chen H, Wang L, Li HW, Wang LX. Comparison of Intravenous plus Oral Pantoprazole Therapy and Oral Pantoprazole Alone for Preventing Gastrointestinal Bleeding in Acute Coronary Syndrome Patients with High Bleeding Risk. Heart Lung Circ. 2015 Sep;24(9):885-90. doi: 10.1016/j.hlc.2015.02.020. Epub 2015 Mar 14. PMID: 25837016.

Yamada S, Wongwanakul P. Randomized controlled trial of high dose bolus versus continuous intravenous infusion pantoprazole as an adjunct therapy to therapeutic endoscopy in massive bleeding peptic ulcer. J Med Assoc Thai. 2012 Mar;95(3):349-57. PMID: 22550833.

Gashi Z, Joksimovic N, Dragusha G, Bakalli A. The efficacy of PPI after endoscopic hemostasis in patients with bleeding peptic ulcer and role of Helicobacter pylori. Med Arch. 2012;66(4):236-9. doi: 10.5455/medarh.2012.66.236-239. PMID: 22919877.

Chen CC, Lee JY, Fang YJ, Hsu SJ, Han ML, Tseng PH, Liou JM, Hu FC, Lin TL, Wu MS, Wang HP, Lin JT. Randomised clinical trial: high-dose vs. standard-dose proton pump inhibitors for the prevention of recurrent haemorrhage after combined endoscopic haemostasis of bleeding peptic ulcers. Aliment Pharmacol Ther. 2012 Apr;35(8):894-903. doi: 10.1111/j.1365-2036.2012.05047.x. Epub 2012 Feb 28. PMID: 22369682.

Sgourakis G, Chatzidakis G, Poulou A, Malliou P, Argyropoulos T, Ravanis G, Vagia A, Kpogho I, Briki A, Tsuruhara H, Stankovičová T. High-dose vs. Low-dose Proton Pump Inhibitors post-endoscopic hemostasis in patients with bleeding peptic ulcer. A meta-analysis and meta-regression analysis. Turk J Gastroenterol. 2018 Jan;29(1):22-31. doi: 10.5152/tjg.2018.17143. PMID: 29391304; PMCID: PMC6322613.

Wong GLH, Lau LHS, Ching JYL, Tse YK, Ling RHY, Wong VWS, Chiu PWY, Lau JYW, Chan FKL. Prevention of recurrent idiopathic gastroduodenal ulcer bleeding: a double-blind, randomised trial. Gut. 2020 Apr;69(4):652-657. doi: 10.1136/gutjnl-2019-318715. Epub 2019 Jun 22. PMID: 31229990

Tsoi KK, Hirai HW, Sung JJ. Meta-analysis: comparison of oral vs. intravenous proton pump inhibitors in patients with peptic ulcer bleeding. Aliment Pharmacol Ther. 2013 Oct;38(7):721-8. doi: 10.1111/apt.12441. Epub 2013 Aug 5. PMID: 23915096.

Laine L, Shah A, Bemanian S. Intragastric pH with oral vs intravenous bolus plus infusion proton-pump inhibitor therapy in patients with bleeding ulcers. Gastroenterology. 2008 Jun;134(7):1836-41. doi: 10.1053/j.gastro.2008.03.006. Epub 2008 Mar 10. PMID: 18423628.

Songür Y, Balkarli A, Acartürk G, Senol A. Comparison of infusion or low-dose proton pump inhibitor treatments in upper gastrointestinal system bleeding. Eur J Intern Med. 2011 Apr;22(2):200-4. doi: 10.1016/j.ejim.2010.11.007. Epub 2010 Dec 18. PMID: 21402254.

Coronel E, Bassi N, Donahue-Rolfe S, Byrne E, Sokol S, Reddy G, Arora VM. Evaluation of a Trainee-Led Project to Reduce Inappropriate Proton Pump Inhibitor Infusion in Patients With Upper Gastrointestinal Bleeding: Skip the Drips. JAMA Intern Med. 2017 Nov 1;177(11):1687-1689. doi: 10.1001/jamainternmed.2017.4851. PMID: 29052711; PMCID: PMC5820704.

Khan RS, Hadi YB, Chima N, Kupec J. Skipping the Drip: Intravenous Proton Pump Inhibitor Bolus Therapy Leads to Poor Outcomes in High-Risk Bleeding. Cureus. 2020 May 30;12(5):e8362. doi: 10.7759/cureus.8362. PMID: 32617233; PMCID: PMC7325381.

Lin HJ, Tsai JJ. Intragastric pH with oral versus intravenous bolus plus infusion proton pump inhibitor therapy in patients with bleeding ulcers. Gastroenterology. 2008 Nov;135(5):1804-5. doi: 10.1053/j.gastro.2008.09.051. Epub 2008 Oct 7. PMID: 18840442.

Histamine-II Blockers

Chan FK, Kyaw M, Tanigawa T, Higuchi K, Fujimoto K, Cheong PK, Lee V, Kinoshita Y, Naito Y, Watanabe T, Ching JY, Lam K, Lo A, Chan H, Lui R, Tang RS, Sakata Y, Tse YK, Takeuchi T, Handa O, Nebiki H, Wu JC, Abe T, Mishiro T, Ng SC, Arakawa T. Similar Efficacy of Proton-Pump Inhibitors vs H2-Receptor Antagonists in Reducing Risk of Upper Gastrointestinal Bleeding or Ulcers in High-Risk Users of Low-Dose Aspirin. Gastroenterology. 2017 Jan;152(1):105-110.e1. doi: 10.1053/j.gastro.2016.09.006. Epub 2016 Sep 15. PMID: 27641510.

Sakurada T, Kawashima J, Ariyama S, Kani K, Takabayashi H, Ohno S, Kato S, Yakabi K. Comparison of adjuvant therapies by an H2-receptor antagonist and a proton pump inhibitor after endoscopic treatment in hemostatic management of bleeding gastroduodenal ulcers. Dig Endosc. 2012 Mar;24(2):93-9. doi: 10.1111/j.1443-1661.2011.01176.x. Epub 2011 Jul 13. PMID: 22348833.

Ng FH, Tunggal P, Chu WM, Lam KF, Li A, Chan K, Lau YK, Kng C, Keung KK, Kwan A, Wong BC. Esomeprazole compared with famotidine in the prevention of upper gastrointestinal bleeding in patients with acute coronary syndrome or myocardial infarction. Am J Gastroenterol. 2012 Mar;107(3):389-96. doi: 10.1038/ajg.2011.385. Epub 2011 Nov 22. PMID: 22108447.

Liu BL, Li B, Zhang X, Fei Z, Hu SJ, Lin W, Gao DK, Zhang L. A randomized controlled study comparing omeprazole and cimetidine for the prophylaxis of stress-related upper gastrointestinal bleeding in patients with intracerebral hemorrhage. J Neurosurg. 2013 Jan;118(1):115-20. doi: 10.3171/2012.9.JNS12170. Epub 2012 Oct 12. PMID: 23061387.

Lilly CM, Aljawadi M, Badawi O, Onukwugha E, Tom SE, Magder LS, Harris I. Comparative Effectiveness of Proton Pump Inhibitors vs Histamine Type 2 Receptor Blockers for Preventing Clinically Important Gastrointestinal Bleeding During Intensive Care: A Population-Based Study. Chest. 2018 Sep;154(3):557-566. doi: 10.1016/j.chest.2018.05.015. Epub 2018 May 30. PMID: 29856970; PMCID: PMC6689080.

MacLaren R, Reynolds PM, Allen RR. Histamine-2 Receptor Antagonists vs Proton Pump Inhibitors on Gastrointestinal Tract Hemorrhage and Infectious Complications in the Intensive Care Unit. JAMA Intern Med. 2014;174(4):564–574. doi:10.1001/jamainternmed.2013.14673

Barletta JF. Histamine-2-Receptor Antagonist Administration and Gastrointestinal Bleeding When Used for Stress Ulcer Prophylaxis in Patients With Severe Sepsis or Septic Shock. Annals of Pharmacotherapy. 2014;48(10):1276-1281. doi:10.1177/1060028014540513

Tranexamic Acid

HALT-IT Trial Collaborators. Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial. Lancet. 2020 Jun 20;395(10241):1927-1936. doi: 10.1016/S0140-6736(20)30848-5. PMID: 32563378; PMCID: PMC7306161.

Gilbert BW, Rech MA. An alternative perspective to just halting tranexamic acid utilization in gastrointestinal bleeding. Am J Emerg Med. 2021 Aug;46:781-782. doi: 10.1016/j.ajem.2020.09.002. Epub 2020 Sep 7. PMID: 32950320.

Flores S, Avilés C, Rada G. Is tranexamic acid effective for acute upper gastrointestinal bleeding? Medwave. 2015 Dec 7;15 Suppl 3:e6330. English, Spanish. doi: 10.5867/medwave.2015.6330. PMID: 26730585.

Karadaş A, Doğan NÖ, Pinar SG, Yeşil O, Pekdemir M, Yilmaz S, Yaka E. A randomized controlled trial of the effects of local tranexamic acid on mortality, rebleeding, and recurrent endoscopy need in patients with upper gastrointestinal hemorrhage. Eur J Gastroenterol Hepatol. 2020 Jan;32(1):26-31. doi: 10.1097/MEG.0000000000001555. PMID: 31567714.

Smith SR, Murray D, Pockney PG, Bendinelli C, Draganic BD, Carroll R. Tranexamic Acid for Lower GI Hemorrhage: A Randomized Placebo-Controlled Clinical Trial. Dis Colon Rectum. 2018 Jan;61(1):99-106. doi: 10.1097/DCR.0000000000000943. PMID: 29215478.

Roberts I, Coats T, Edwards P, Gilmore I, Jairath V, Ker K, Manno D, Shakur H, Stanworth S, Veitch A. HALT-IT–tranexamic acid for the treatment of gastrointestinal bleeding: study protocol for a randomised controlled trial. Trials. 2014 Nov 19;15:450. doi: 10.1186/1745-6215-15-450. PMID: 25409738; PMCID: PMC4253634.

Rafeey M, Shoaran M, Ghergherechi R. Topical tranexamic acid as a novel treatment for bleeding peptic ulcer: A randomised controlled trial. Afr J Paediatr Surg. 2016 Jan-Mar;13(1):9-13. doi: 10.4103/0189-6725.181700. PMID: 27251517; PMCID: PMC4955451.

Tranexamic acid should be avoided for acute gastrointestinal bleeds. Drug Ther Bull. 2021 Jun;59(6):84. doi: 10.1136/dtb.2021.000016. Epub 2021 Mar 22. PMID: 33753352.

Ocreotide and Somatostatin

Seo YS, Park SY, Kim MY, Kim JH, Park JY, Yim HJ, Jang BK, Kim HS, Hahn T, Kim BI, Heo J, An H, Tak WY, Baik SK, Han KH, Hwang JS, Park SH, Cho M, Um SH. Lack of difference among terlipressin, somatostatin, and octreotide in the control of acute gastroesophageal variceal hemorrhage. Hepatology. 2014 Sep;60(3):954-63. doi: 10.1002/hep.27006. Epub 2014 Jul 25. PMID: 24415445.

Kroon S, Snijder RJ, Mager JJ, Post MC, Tenthof van Noorden J, van Geenen EJM, Drenth JPH, Grooteman KV. Octreotide for gastrointestinal bleeding in hereditary hemorrhagic telangiectasia: A prospective case series. Am J Hematol. 2019 Sep;94(9):E247-E249. doi: 10.1002/ajh.25563. Epub 2019 Jul 9. PMID: 31251413.

Grooteman KV, van Geenen EJ, Drenth JP. Multicentre, open-label, randomised, parallel-group, superiority study to compare the efficacy of octreotide therapy 40 mg monthly versus standard of care in patients with refractory anaemia due to gastrointestinal bleeding from small bowel angiodysplasias: a protocol of the OCEAN trial. BMJ Open. 2016 Sep 12;6(9):e011442. doi: 10.1136/bmjopen-2016-011442. PMID: 27619827; PMCID: PMC5030574.

Rengasamy S, Ali SM, Sistla SC, Lakshmi CP, Harichandra Kumar KT. Comparison of 2 days versus 5 days of octreotide infusion along with endoscopic therapy in preventing early rebleed from esophageal varices: a randomized clinical study. Eur J Gastroenterol Hepatol. 2015 Apr;27(4):386-92. doi: 10.1097/MEG.0000000000000300. PMID: 25874510.

Qi BX, Zhu L, Shang L, Sheng LP, Hu BL, Gao K. [Clinical effect and safety of somatostatin in treatment of postoperative gastrointestinal bleeding in neonates]. Zhongguo Dang Dai Er Ke Za Zhi. 2016 Nov;18(11):1065-1068. Chinese. doi: 10.7499/j.issn.1008-8830.2016.11.002. PMID: 27817766; PMCID: PMC7389866.

Hung TH, Tsai CC, TsenK GC, Hsieh YH, Tseng CW. No mortality difference following treatment with terlipressin or somatostatin in cirrhotic patients with gastric variceal hemorrhage. Saudi J Gastroenterol. 2016 May-Jun;22(3):220-5. doi: 10.4103/1319-3767.182458. PMID: 27184641; PMCID: PMC4898092.

Choi CW, Kang DH, Kim HW, et al. Somatostatin adjunctive therapy for non-variceal upper gastrointestinal rebleeding after endoscopic therapy. World J Gastroenterol. 2011;17(29):3441-3447. doi:10.3748/wjg.v17.i29.3441

A J Torres, I Landa, F Hernández, J M Jover, A Suárez, J Arias, Rosa Cuberes, J Santoyo, Rosa Fernández, J Calleja, Elena Nisa, J L Rodriguez, E Moreno, J L Balibrea, Somatostatin in the treatment of severe upper gastrointestinal bleeding: A multicentre controlled trial, British Journal of Surgery, Volume 73, Issue 10, October 1986, Pages 786–789, https://doi.org/10.1002/bjs.1800731009

Julie Martin-Grace, Gianluca Tamagno, “Somatostatin Analogs in the Medical Management of Occult Bleeding of the Lower Digestive Tract”, Gastroenterology Research and Practice, vol. 2015, Article ID 702921, 5 pages, 2015. https://doi.org/10.1155/2015/702921

Blood Transfusion

Villanueva C, Colomo A, Bosch A, Concepción M, Hernandez-Gea V, Aracil C, Graupera I, Poca M, Alvarez-Urturi C, Gordillo J, Guarner-Argente C, Santaló M, Muñiz E, Guarner C. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med. 2013 Jan 3;368(1):11-21. doi: 10.1056/NEJMoa1211801. Erratum in: N Engl J Med. 2013 Jun 13;368(24):2341. PMID: 23281973.

Jairath V, Kahan BC, Gray A, Doré CJ, Mora A, James MW, Stanley AJ, Everett SM, Bailey AA, Dallal H, Greenaway J, Le Jeune I, Darwent M, Church N, Reckless I, Hodge R, Dyer C, Meredith S, Llewelyn C, Palmer KR, Logan RF, Travis SP, Walsh TS, Murphy MF. Restrictive versus liberal blood transfusion for acute upper gastrointestinal bleeding (TRIGGER): a pragmatic, open-label, cluster randomised feasibility trial. Lancet. 2015 Jul 11;386(9989):137-44. doi: 10.1016/S0140-6736(14)61999-1. Epub 2015 May 5. PMID: 25956718.

Kola G, Sureshkumar S, Mohsina S, Sreenath GS, Kate V. Restrictive versus liberal transfusion strategy in upper gastrointestinal bleeding: A randomized controlled trial. Saudi J Gastroenterol. 2021 Jan-Feb;27(1):13-19. doi: 10.4103/sjg.SJG_152_20. PMID: 32801255; PMCID: PMC8083250.

Al-Jaghbeer M, Yende S. Blood transfusion for upper gastrointestinal bleeding: is less more again? Crit Care. 2013 Sep 24;17(5):325. doi: 10.1186/cc13020. PMID: 24063362; PMCID: PMC4056793.

Handel J, Lang E. Transfusion strategy for acute upper gastrointestinal bleeding. CJEM. 2015 Sep;17(5):582-5. doi: 10.1017/cem.2014.76. Epub 2015 Apr 10. PMID: 26013300.

Kahan BC, Jairath V, Murphy MF, Doré CJ. Update on the transfusion in gastrointestinal bleeding (TRIGGER) trial: statistical analysis plan for a cluster-randomised feasibility trial. Trials. 2013 Jul 10;14:206. doi: 10.1186/1745-6215-14-206. PMID: 23837630; PMCID: PMC3716978.

Wang J, Bao YX, Bai M, Zhang YG, Xu WD, Qi XS. Restrictive vs liberal transfusion for upper gastrointestinal bleeding: a meta-analysis of randomized controlled trials. World J Gastroenterol. 2013 Oct 28;19(40):6919-27. doi: 10.3748/wjg.v19.i40.6919. PMID: 24187470; PMCID: PMC3812494.

Jairath V, Kahan BC, Gray A, Doré CJ, Mora A, Dyer C, Stokes EA, Llewelyn C, Bailey AA, Dallal H, Everett SM, James MW, Stanley AJ, Church N, Darwent M, Greenaway J, Le Jeune I, Reckless I, Campbell HE, Meredith S, Palmer KR, Logan RF, Travis SP, Walsh TS, Murphy MF. Restrictive vs liberal blood transfusion for acute upper gastrointestinal bleeding: rationale and protocol for a cluster randomized feasibility trial. Transfus Med Rev. 2013 Jul;27(3):146-53. doi: 10.1016/j.tmrv.2013.04.001. Epub 2013 May 22. PMID: 23706959; PMCID: PMC4046243.
Karaca MA, Erbil B, Ozmen MM. Use and effectiveness of prothrombin complex concentrates vs fresh frozen plasma in gastrointestinal hemorrhage due to warfarin usage in the ED. Am J Emerg Med. 2014 Jun;32(6):660-4. doi: 10.1016/j.ajem.2014.02.016. Epub 2014 Feb 24. PMID: 24661780.

Review Articles

Mujtaba S, Chawla S, Massaad JF. Diagnosis and Management of Non-Variceal Gastrointestinal Hemorrhage: A Review of Current Guidelines and Future Perspectives. J Clin Med. 2020;9(2):402. Published 2020 Feb 2. doi:10.3390/jcm9020402
Bond A, Smith PJ. British Society of Gastroenterology: diagnosis and management of acute lower gastrointestinal bleeding. Frontline Gastroenterol. 2019 Oct;10(4):417-420. doi: 10.1136/flgastro-2019-101220

Al Duhailib Z, Dionne JC, Alhazzani W. Management of severe upper gastrointestinal bleeding in the ICU. Curr Opin Crit Care. 2020 Apr;26(2):212-218. doi: 10.1097/MCC.0000000000000699

Kherad O, Restellini S, Martel M, Barkun A. Proton pump inhibitors for upper gastrointestinal bleeding. Best Pract Res Clin Gastroenterol. 2019 Oct-Dec;42-43:101609. doi: 10.1016/j.bpg.2019.04.002. Epub 2019 Apr 17. PMID: 31785730.

Sachar H, Vaidya K, Laine L. Intermittent vs continuous proton pump inhibitor therapy for high-risk bleeding ulcers: a systematic review and meta-analysis. JAMA Intern Med. 2014 Nov;174(11):1755-62. doi: 10.1001/jamainternmed.2014.4056. PMID: 25201154; PMCID: PMC4415726.

Wang Y, Ye Z, Ge L, Siemieniuk RAC, Wang X, Wang Y, Hou L, Ma Z, Agoritsas T, Vandvik PO, Perner A, Møller MH, Guyatt GH, Liu L. Efficacy and safety of gastrointestinal bleeding prophylaxis in critically ill patients: systematic review and network meta-analysis. BMJ. 2020 Jan 6;368:l6744. doi: 10.1136/bmj.l6744. PMID: 31907166; PMCID: PMC7190057.

Toews I, George AT, Peter JV, Kirubakaran R, Fontes LES, Ezekiel JPB, Meerpohl JJ. Interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units. Cochrane Database Syst Rev. 2018 Jun 4;6(6):CD008687. doi: 10.1002/14651858.CD008687.pub2. PMID: 29862492; PMCID: PMC6513395.

Wang Y, Ge L, Ye Z, Siemieniuk RA, Reintam Blaser A, Wang X, Perner A, Møller MH, Alhazzani W, Cook D, Guyatt GH. Efficacy and safety of gastrointestinal bleeding prophylaxis in critically ill patients: an updated systematic review and network meta-analysis of randomized trials. Intensive Care Med. 2020 Nov;46(11):1987-2000. doi: 10.1007/s00134-020-06209-w. Epub 2020 Aug 24. PMID: 32833040.
Worden JC, Hanna KS. Optimizing proton pump inhibitor therapy for treatment of nonvariceal upper gastrointestinal bleeding. Am J Health Syst Pharm. 2017 Feb 1;74(3):109-116. doi: 10.2146/ajhp151032. PMID: 28122752.

Rodriguez EA, Donath E, Waljee AK, Sussman DA. Value of Oral Proton Pump Inhibitors in Acute, Nonvariceal Upper Gastrointestinal Bleeding: A Network Meta-Analysis. J Clin Gastroenterol. 2017 Sep;51(8):707-719. doi: 10.1097/MCG.0000000000000625. PMID: 27505402.

Bennett C, Klingenberg SL, Langholz E, Gluud LL. Tranexamic acid for upper gastrointestinal bleeding. Cochrane Database Syst Rev. 2014 Nov 21;2014(11):CD006640. doi: 10.1002/14651858.CD006640.pub3. PMID: 25414987; PMCID: PMC6599825.

Twum-Barimah E, Abdelgadir I, Gordon M, Akobeng AK. Systematic review with meta-analysis: the efficacy of tranexamic acid in upper gastrointestinal bleeding. Aliment Pharmacol Ther. 2020 Jun;51(11):1004-1013. doi: 10.1111/apt.15761. Epub 2020 May 3. PMID: 32363690.

Lee PL, Yang KS, Tsai HW, Hou SK, Kang YN, Chang CC. Tranexamic acid for gastrointestinal bleeding: A systematic review with meta-analysis of randomized clinical trials. Am J Emerg Med. 2021 Jul;45:269-279. doi: 10.1016/j.ajem.2020.08.062. Epub 2020 Aug 29. PMID: 33041136.

Jiang M, Chen P, Gao Q. Systematic Review and Net-Work Meta-Analysis of Upper Gastrointestinal Hemorrhage Interventions. Cell Physiol Biochem. 2016;39(6):2477-2491. doi: 10.1159/000452515. Epub 2016 Nov 14. PMID: 27855401.

Wang C, Han J, Xiao L, Jin CE, Li DJ, Yang Z. Efficacy of vasopressin/terlipressin and somatostatin/octreotide for the prevention of early variceal rebleeding after the initial control of bleeding: a systematic review and meta-analysis. Hepatol Int. 2015 Jan;9(1):120-9. doi: 10.1007/s12072-014-9594-9. Epub 2014 Dec 5. PMID: 25788386.

Odutayo A, Desborough MJ, Trivella M, Stanley AJ, Dorée C, Collins GS, Hopewell S, Brunskill SJ, Kahan BC, Logan RF, Barkun AN, Murphy MF, Jairath V. Restrictive versus liberal blood transfusion for gastrointestinal bleeding: a systematic review and meta-analysis of randomised controlled trials. Lancet Gastroenterol Hepatol. 2017 May;2(5):354-360. doi: 10.1016/S2468-1253(17)30054-7. Epub 2017 Mar 23. PMID: 28397699.

Kherad O, Restellini S, Almadi M, Strate LL, Ménard C, Martel M, Roshan Afshar I, Sadr MS, Barkun AN. Systematic review with meta-analysis: limited benefits from early colonoscopy in acute lower gastrointestinal bleeding. Aliment Pharmacol Ther. 2020 Sep;52(5):774-788. doi: 10.1111/apt.15925. Epub 2020 Jul 22. PMID: 32697886.

Csiki E, Szabó H, Hanák L, Szakács Z, Kiss S, Vörhendi N, Pécsi D, Hegyi E, Hegyi P, Erőss B. Oral Proton Pump Inhibitors May Be as Effective as Intravenous in Peptic Ulcer Bleeding: A Systematic Review and Meta-analysis. Clin Transl Gastroenterol. 2021 Apr 14;12(4):e00341. doi: 10.14309/ctg.0000000000000341. PMID: 33988530; PMCID: PMC8049165.

Academic Life In Emergency Medicine. Rezaie, Salim. Upper Gastrointestinal Bleeding: Evidence-Based Treatment. Accessed: 20 October 2021.

PSAP. Management and Prevention of Upper GI Bleeding by Jiwon Kim. Accessed: 20 October 2021.

Neumann I, Letelier LM, Rada G, Claro JC, Martin J, Howden CW, Yuan Y, Leontiadis GI. Comparison of different regimens of proton pump inhibitors for acute peptic ulcer bleeding. Cochrane Database Syst Rev. 2013 Jun 12;(6):CD007999. doi: 10.1002/14651858.CD007999.pub2. PMID: 23760821.

Sachar H, Vaidya K, Laine L. Intermittent vs continuous proton pump inhibitor therapy for high-risk bleeding ulcers: a systematic review and meta-analysis. JAMA Intern Med. 2014;174(11):1755-1762. doi:10.1001/jamainternmed.2014.4056

Podcasts & Medical Blogs

Lower Gastrointestinal Bleeding: Evaluation, Management, and Disposition- http://www.emdocs.net/lower-gastrointestinal-bleeding-evaluation-management-and-disposition/
Massive GI bleed management- https://first10em.com/management-of-the-massive-gi-bleed/
Upper Gastro Intestinal Bleeding at St.Emlyn’s.- https://www.stemlynsblog.org/upper-gastro-intestinal-bleeding-at-st-emlyns/
The Good, The Bad, and The Ugly of Proton Pump Inhibitors in UGIB- https://rebelem.com/good-bad-ugly-proton-pump-inhibitors-ugib/

GI Bleeding- https://emcrit.org/ibcc/gib/
Episode 101 GI Bleed Emergencies Part 1- https://emergencymedicinecases.com/gi-bleed-emergencies-part-1/
REBEL Cast Ep85: The HALT-IT Trial – TXA in Acute GI Bleeds- https://rebelem.com/rebel-cast-ep85-the-halt-it-trial-txa-in-acute-gi-bleeds/

REBEL Cast Ep 48: Octreotide and Somatostatin for Undifferentiated Upper Gastrointestinal Bleed- https://rebelem.com/rebel-cast-ep-48-octreotide-somatostatin-undifferentiated-upper-gastrointestinal-bleed/

GI Bleeding- https://www.emrap.org/episode/february2004/gibleeding

Critical Care Mailbag: Upper GI Bleed- https://www.emrap.org/episode/emrap2020june/criticalcare

Paper Chase 2: Upper GI Bleeds- https://www.emrap.org/episode/december2013/paperchase2

Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding- https://www.emrap.org/episode/emrap2020june1/timingof
Episode 16- “HALT” the use of TXA in GI bleeds? – https://errxpodcast.com/txa-gi-bleed/

Acute Upper and Lower Gastrointestinal Bleeding Reference Library

Participants 97

Rabbit Hole: Acute Upper and Lower Gastrointestinal Bleeding

Riszel October 28, 2021

Guidelines

Primary Literature

Review Articles

Podcasts & Medical Blogs