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
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is 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 also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.