Upper Gastrointestinal Bleeding An Issue Of Gastroenterology Clinics Of North America E Book

This issue of Gastroenterology Clinics of North America is all about acute upper GI bleeding and is divided into two distinct sections: section I is devoted to nonvariceal upper GI bleeding and section II is devoted to variceal upper GI bleeding. Acute nonvariceal upper GI bleeding may originate from the esophagus, stomach, or duodenum, essentially anywhere proximal to the Ligament of Treitz. In Section I, Dr Gianluca Rotondano, Hospital Maresca, Torre del Greco, Italy, begins with a review of the epidemiology and diagnosis of acute nonvariceal upper GI bleeding. We then turn to patient presentation, risk stratification, and how to initially medically manage these bleeding patients. I am pleased to have one of our emergency medicine colleagues, Dr Andrew Meltzer, Department of Emergency Medicine, George Washington University, contribute this important article and provide a unique viewpoint from the emergency department where most of these patients initially present. As we all know, endoscopic hemostasis is the accepted standard of care for patients with acute nonvariceal upper GI bleeding. Moreover, peptic ulcer bleeding is the most common nonvariceal cause of acute upper GI bleeding; thus, Drs Yidan Lu, Yen-I Chen, and Alan Barkun from McGill University, Montreal, Canada, provide an in-depth review of the endoscopic management of peptic ulcer bleeding. Drs Eric Tjwa, I. Lisanne Holster, and Ernst Kuipers from the Erasmus Medical Center University Hospital, Rotterdam, The Netherlands, review the endoscopic management of all other causes of acute nonvariceal upper GI bleeding, and in addition, Drs Louis Wong Kee Song and Michael Levy from the Mayo Clinic, Rochester, Minnesota discuss emerging endoscopic hemostasis treatments, such as topical sprays and over-the-scope clipping devices. Although endoscopic hemostasis is very highly effective, there are unfortunately cases where bleeding is unable to be controlled or when significant rebleeding occurs that is not amenable to endoscopic therapy. Therefore, I have included two articles that provide insight into the question...what if endoscopic hemostasis fails? The first article, written by Drs Philip Wai Yan Chiu and James Yun Wong Lau, from Prince of Wales Hospital, The Chinese University of Hong Kong, focuses on tried and true surgical treatment options. The second article, by Dr Sujal Nanavati, University of California at San Francisco, Department of Radiology and Biomedical Imaging, addresses the alternative treatment strategy of angiographic embolization, which has now emerged as the often preferred salvage treatment strategy.

This group of international experts on gastrointestinal bleeding have written state-of-the art reviews on the overall approach to gastrointestinal bleeding. Endoscopists will find in this issue coverage of the endoscopic, surgical and pharmacologic therapies as well as competency and sedation issues. Other articles focus on the epidemiology, pathology, and the prevalence and incidence of H. Pylori in upper gastrointestinal bleeding.

Upper gastrointestinal bleeding is the leading emergency leading to hospitalization and urgent endoscopy. The field of gastrointestinal bleeding is rapidly evolving. The epidemiology is changing with more complex older patients on anticoagulant and antithrombotic agents presenting with upper gastrointestinal bleeding. The initial management has rapidly evolved with new transfusion thresholds, the use of risk stratification scores and no more nasogastric tubes. There is new data and recommendations on optimal timing of endoscopy. Medical therapies have also evolved with changes in proton pump inhibitor administration and the use of prokinetics to improve endoscopic visualization. Many modifications in endoscopic therapy have recently been advanced including the use of endoscopic ultrasound guided angiotherapy, topical sprays (i.e. Hemospray) and over-the-scope clips. In order to give optimal care to patients, it is critical that practicing gastroenterologists are aware of the many recent advances in management of patients with upper gastrointestinal bleeding.

In this issue of Gastroenterology Clinics, Guest Editors M. Nedim. N. Ince and David E. Elliott bring their considerable expertise to the topic of Gastrointestinal Infections. Top experts in the field cover key topics such as Candida esophagitis, Acute bacterial gastroenteritis, Clostridium difficile infection and antibiotic-associated diarrhea, and more. Provides concise and comprehensive coverage of the issues physicians face every day. Presents the latest information on a timely, focused topic under the leadership of experienced editors in the field. Contains 14 relevant, practice-oriented topics including Helicobacter pylori infection; Viral gastroenteritis in special patient populations; Rare causes of hepatitis; Postinfectious irritable bowel syndrome; and more.

In this issue of Gastrointestinal Endoscopy Clinics of North America, guest editor Dr. Patrick Pfau brings his considerable expertise to the topic of Gastrointestinal Bleeding. Top experts in the field cover a broad range of topics on the diagnosis and treatment of both upper and lower gastrointestinal bleeding with a concentration on endoscopic intervention. This issue discusses the preparation of the patient with a GI bleed even before endoscopy is performed, and provides extensive coverage of the latest data and technology for variceal and non-variceal upper GI tract bleeding, small bowel/occult, and lower GI and colonic bleeding. Contains 12 relevant, practice-oriented topics including endoscopic diagnosis, grading, and treatment of bleeding peptic ulcer disease; variceal and non-variceal upper gastrointestinal bleeding refractory to endoscopic management: indications and role of interventional radiology; diagnosis of occult and obscure gastrointestinal bleeding; endoscopic treatment of small bowel bleeding; endoscopic diagnosis and treatment of colonic diverticular bleeding; and more. Provides in-depth clinical reviews on gastrointestinal bleeding, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

In this issue, guest editors bring their considerable expertise to this important topic. Provides in-depth reviews on the latest updates in the field, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.