Expert Review of Nonvariceal Upper Gastrointestinal Bleeding Management

The management of nonvariceal upper gastrointestinal bleeding (NVUGIB) is rapidly changing due to multiple advances in initial assessment, blood transfusion, timing of endoscopy, and endoscopic technique. The American Gastroenterological Association (AGA) commissioned a review framed around ten key practice advice points agreed upon by three expert authors. Some highlights are as follows:

• Initial patient management should focus on resuscitation, triage, and preparation for upper endoscopy. Following stabilization, endoscopy should be done with endoscopic treatment of active bleeding or high-risk stigmata for rebleeding.

• Endoscopic therapy should achieve hemostasis in the majority of patients with NVUGIB.

• Endoscopists should be comfortable appl…