A new guideline to improve the management and mortality rate of acute upper gastrointestinal (GI) bleeding has been published by NICE.
It includes key recommendations such as the continued use of low-dose aspirin for secondary prevention of vascular events and patients with severe GI bleeding being offered endoscopy immediately after resuscitation.
Despite changes in the management of the condition, mortality rates have not improved in half a century with around 5,000 deaths per year in the UK recorded.
Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, hoped the guideline would be a “useful aid to all healthcare professionals”.
Bleeding in the oesophagus, stomach or duodenum is the most common emergency managed by gastroenterologists in the UK – resulting in 50,000 hospital admissions annually.
It is estimated that around 1 in 10 admissions for upper GI bleeding end in the patient’s death.
The new guideline also recommends endoscopy being offered within 24 hours of admission to all other patients with upper GI bleeding and interventional radiology to unstable patients who re-bleed after endoscopic treatment.
“Although there have been changes in how upper gastrointestinal tract bleeding is managed, mortality has not improved much over the past 50 years and thousands of people still die from the condition every year,” said Professor Baker.
“We are, therefore, pleased to be publishing this guideline on the management of acute upper gastrointestinal bleeding.”
Risk assessment, resuscitation and initial management, timing of endoscopy, controlling bleeding and preventing re-bleeding, plus information and support for patients and carers are also addressed within the guideline.
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