A new international consensus guideline has been published on the management of non-variceal upper GI bleeding (guidelines). Among the highlights, the guidelines stress the use of prognostic staging and early endoscopy. Post endoscopy, low risk patients should be candidates for early discharge, while high risk patients should be observed for re-bleeding on high-dose IV PPIs for 72 hours. ASA should be restarted within 7 days for those who require it (and ASA+PPI is preferred over clopidogrel). For those requiring NSAIDs, a PPI with a COX-2 inhibitor is preferred. In peptic ulcers, test (and treat) for Hpylori
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February 18, 2010 |
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About the Author: Danielle Scheurer
Danielle Scheurer, MD, MSCR, SFHM is a clinical hospitalist and the Chief Quality Officer at the Medical University of South Carolina in Charleston, South Carolina, where she also serves as Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She is also the President of SHM's Board of Directors and previously served as Physician Editor of The Hospitalist, SHM's monthly newsmagazine.
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