Management of Nonvariceal Upper Gastrointestinal Bleeding
Authors: Alan N. Barkun, Loren Laine, Grigorios I. Leontiadis, Marc Bardou
Journal: Annals of Internal Medicine (2020)

Letters21 April 2020Management of Nonvariceal Upper Gastrointestinal BleedingAlan N. Barkun, MD, Loren Laine, MD, Grigorios I. Leontiadis, MD, and Marc Bardou, MDAlan N. Barkun, MDMcGill University, Montreal, Quebec, Canada (A.N.B.), Loren Laine, MDYale School of Medicine, New Haven, Connecticut (L.L.), Grigorios I. Leontiadis, MDMcMaster University, Hamilton, Ontario, Canada (G.I.L.), and Marc Bardou, MDDijon-Bourgogne University Hospital, Dijon, France (M.B.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We acknowledge the existing evidence on the possible use of nasogastric intubation. We also congratulate Dr. Karakonstantis on his systematic review, which was published after our search date had ended (1). The recommendation for nasogastric intubation was not selected for revision because group members did not consider it a priority; in contrast, information on many other emerging, more practice-changing areas of interest needed to be revised from our past guidelines or added. Nevertheless, we agree that placement of a nasogastric tube provides only modest prognostic information that is based on very low certainty of evidence. It is thus ...References1. Karakonstantis S, Tzagkarakis E, Kalemaki D, et al. Nasogastric aspiration/lavage in patients with gastrointestinal bleeding: a review of the evidence. Expert Rev Gastroenterol Hepatol. 2018;12:63-72. [PMID: 29098897] CrossrefMedlineGoogle Scholar2. Gralnek IM, Dumonceau JM, Kuipers EJ, et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2015;47:a1-46. [PMID: 26417980] CrossrefMedlineGoogle Scholar3. Laine L, Jensen DM. Management of patients with ulcer bleeding. Am J Gastroenterol. 2012;107:345-60. [PMID: 22310222] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: McGill University, Montreal, Quebec, Canada (A.N.B.)Yale School of Medicine, New Haven, Connecticut (L.L.)McMaster University, Hamilton, Ontario, Canada (G.I.L.)Dijon-Bourgogne University Hospital, Dijon, France (M.B.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-1795. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group Alan N. Barkun , Majid Almadi , Ernst J. Kuipers , Loren Laine , Joseph Sung , Frances Tse , Grigorios I. Leontiadis , Neena S. Abraham , Xavier Calvet , Francis K.L. Chan , James Douketis , Robert Enns , Ian M. Gralnek , Vipul Jairath , Dennis Jensen , James Lau , Gregory Y.H. Lip , Romaric Loffroy , Fauze Maluf-Filho , Andrew C. Meltzer , Nageshwar Reddy , John R. Saltzman , John K. Marshall , and Marc Bardou Management of Nonvariceal Upper Gastrointestinal Bleeding Stamatis Karakonstantis Metrics Cited byAnticoagulant‐associated gastrointestinal bleeding: Framework for decisions about whether, when and how to resume anticoagulantsA Practical Guide to Establishing a Gastroenterology Hospitalist ProgramStudy on the preventive effect of intravenous esomeprazole in the management of nonvarices upper gastrointestinal bleeding 21 April 2020Volume 172, Issue 8Page: 573KeywordsDisclosureHemorrhageIntubationSystematic reviewsTreatment guidelines ePublished: 21 April 2020 Issue Published: 21 April 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...