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Guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding
Author(s) -
Fujishiro Mitsuhiro,
Iguchi Mikitaka,
Kakushima Naomi,
Kato Motohiko,
Sakata Yasuhisa,
Hoteya Shu,
Kataoka Mikinori,
Shimaoka Shunji,
Yahagi Naohisa,
Fujimoto Kazuma
Publication year - 2016
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12639
Subject(s) - medicine , upper gastrointestinal bleeding , hemostasis , peptic , gastrointestinal bleeding , endoscopy , helicobacter pylori , population , gastroenterology , peptic ulcer , general surgery , surgery , environmental health
Japan Gastroenterological Endoscopy Society (JGES) has compiled a set of guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding using evidence‐based methods. The major cause of non‐variceal upper gastrointestinal bleeding is peptic gastroduodenal ulcer bleeding. As a result, these guidelines mainly focus on peptic gastroduodenal ulcer bleeding, although bleeding from other causes is also overviewed. From the epidemiological aspect, in recent years in Japan, bleeding from drug‐related ulcers has become predominant in comparison with bleeding from Helicobacter pylori ( HP )‐related ulcers, owing to an increase in the aging population and coverage of HP eradication therapy by national health insurance. As for treatment, endoscopic hemostasis, in which there are a variety of methods, is considered to be the first‐line treatment for bleeding from almost all causes. It is very important to precisely evaluate the severity of the patient's condition and stabilize the patient's vital signs with intensive care for successful endoscopic hemostasis. Additionally, use of antisecretory agents is recommended to prevent rebleeding after endoscopic hemostasis, especially for gastroduodenal ulcer bleeding. Eighteen statements with evidence and recommendation levels have been made by the JGES committee of these guidelines according to evidence obtained from clinical research studies. However, some of the statements that are supported by a low level of evidence must be confirmed by further clinical research.