Nonvariceal Upper Gastrointestinal Bleeding

Khamaysi, Iyad; Gralnek, Ian M.

doi:10.1016/j.giec.2015.03.002

Cited by 10 publications

(3 citation statements)

References 28 publications

(43 reference statements)

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“…A standard pre-endoscopic preparation along with early endoscopy in all participants led to a high success rate of lesion identification in our study, which is comparable with previous reports 26 . The proportion of identified lesions was non-statistically significant between metoclopramide and placebo groups due to multiple reasons: first, more than half of our patients presented with melena, which was bound to reveal less blood content in the proximal stomach as compared to fresh blood/hematemesis, and second, apart from the use of pre-endoscopic prokinetic agents, identification of lesions may depend on the expertise of endoscopists including the endoscopic techniques.…”

Section: Discussionsupporting

confidence: 92%

Intravenous metoclopramide for increasing endoscopic mucosal visualization in patients with acute upper gastrointestinal bleeding: a multicenter, randomized, double-blind, controlled trial

Manupeeraphant,

Wanichagool,

Songlin

et al. 2024

Sci Rep

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Acute upper gastrointestinal hemorrhage (UGIH) is the most common emergency condition that requires rapid endoscopic treatment. This study aimed to evaluate the effects of pre-endoscopic intravenous metoclopramide on endoscopic mucosal visualization (EMV) in patients with acute UGIH. This was a multicenter, randomized, double-blind controlled trial of participants diagnosed with acute UGIH. All participants underwent esophagogastroduodenoscopy within 24 h. Participants were assigned to either the metoclopramide or placebo group. Modified Avgerinos scores were evaluated during endoscopy. In total, 284 out of 300 patients completed the per-protocol procedure. The mean age was 62.8 ± 14.3 years, and 67.6% were men. Metoclopramide group achieved a higher total EMV and gastric body EMV score than the other group (7.34 ± 1.1 vs 6.94 ± 1.6; P = 0.017 and 1.80 ± 0.4 vs 1.64 ± 0.6; P = 0.006, respectively). Success in identifying lesions was not different between the groups (96.5% in metoclopramide and 93.6% in placebo group; P = 0.26). In the metoclopramide group, those with active variceal bleeding compared with the control group demonstrated substantial improvements in gastric EMV (1.83 ± 0.4 vs 1.28 ± 0.8, P = 0.004), antral EMV (1.96 ± 0.2 vs 1.56 ± 0.6, P = 0.003), and total EMV score (7.48 ± 1.1 vs 6.2 ± 2.3, P = 0.02). Pre-endoscopic intravenous metoclopramide improved the quality of EMV in variceal etiologies of UGIH, which was especially prominent in those who had signs of active bleeding based on nasogastric tube assessment.Trial Registration: Trial was registered in Clinical Trials: TCTR 20210708004 (08/07/2021).

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Section: Discussionsupporting

confidence: 92%

Intravenous metoclopramide for increasing endoscopic mucosal visualization in patients with acute upper gastrointestinal bleeding: a multicenter, randomized, double-blind, controlled trial

Manupeeraphant,

Wanichagool,

Songlin

et al. 2024

Sci Rep

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“…9,75--- 77 The rate of false negatives is high when the Hp detection tests are conducted during an acute bleeding episode. The risk of rebleeding diminishes almost completely with Hp eradication.…”

Section: Helicobacter Pylori Infectionmentioning

confidence: 99%

Management of non variceal upper gastrointestinal bleeding: Position paper statement of the Catalan Society of Gastroenterology

García-Iglesias

Botargues

Caballé

et al. 2017

Gastroenterología y Hepatología (English Edition)

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“…Endoscopy has become the standard of care in the diagnosis and treatment of UGIB. Most national and international guidelines recommend performing upper endoscopy within 24 hours of presentation in patients with UGIB [5][6][7] . Despite major advances in diagnostic and therapeutic approaches, PUB remains a signifi cant problem and an important cause of morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Bleeding Peptic Ulcer – Tertiary Center Experience: Epidemiology, Treatment and Prognosis

Budimir

Stojsavljević

Hrabar

et al. 2017

ACC

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SUMMARY -Th e aim of this study was to demonstrate epidemiological, clinical and endoscopic characteristics of acute upper gastrointestinal bleeding (UGIB) with special reference to peptic ulcer bleeding (PUB). Th e study included 2198 consecutive patients referred to our emergency department due to acute UGIB from January 2008 to December 2012. All patients underwent urgent upper GI endoscopy within 24 hours of admission, and 842 patients diagnosed with PUB were enrolled and prospectively followed-up. Th e cumulative incidence of UGIB was 126/100,000 in the 5-year period. Two out of fi ve patients had a bleeding peptic ulcer; in total, 440 (52.3%) had bleeding gastric ulcer, 356 (42.3%) had bleeding duodenal ulcer, 17 (2%) had both bleeding gastric and duodenal ulcers, and 29 (3.5%) patients had bleeding ulcers on gastroenteric anastomoses. PUB was more common in men. Th e mean patient age was 65.9 years. Th e majority of patients (57%) with PUB were taking agents that attenuate the cytoprotective function of gastric and duodenal mucosa. Rebleeding occurred in 77 (9.7%) patients and 47 (5.9%) patients required surgical intervention. Th e 30-day morality was 5.2% and 10% of patients died from uncontrolled bleeding and concomitant diseases. In conclusion, PUB is the main cause of UGIB, characterized by a signifi cant rebleeding rate and mortality.

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Nonvariceal Upper Gastrointestinal Bleeding

Cited by 10 publications

References 28 publications

Intravenous metoclopramide for increasing endoscopic mucosal visualization in patients with acute upper gastrointestinal bleeding: a multicenter, randomized, double-blind, controlled trial

Intravenous metoclopramide for increasing endoscopic mucosal visualization in patients with acute upper gastrointestinal bleeding: a multicenter, randomized, double-blind, controlled trial

Management of non variceal upper gastrointestinal bleeding: Position paper statement of the Catalan Society of Gastroenterology

Bleeding Peptic Ulcer – Tertiary Center Experience: Epidemiology, Treatment and Prognosis

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