Upper gastrointestinal bleeding natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Natural History, Complications, and Prognosis
Natural History
- The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
- The symptoms of (disease name) typically develop ___ years after exposure to ___.
- If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
Complications
Complications of UGIB include:[1]
- End-organ damage
- Cardiac ischemia
- Renal failure
- Ischemic hepatitis
- Anoxic brain injury
- Iron-deficiency anemia
Prognosis
- Prognosis is generally good with appropriate treatment, and the 1-year mortality rate of patients with nonvariceal UGIB is approximately 10%.[2][3][4][5]
- In UGIB, the prognosis doesn't depend on the severity of bleeding but depends upon patients age and comorbid conditions.
- The majority of patients with UGIB will stop bleeding spontaneously.
- A clean ulcer base has less than a 3% chance of rebleeding; therefore, these lesions are not usually treated or scoped again.
- In otherwise stable patients, patients with a clean ulcer base has less than a 3% chance of rebleeding and are good candidates for early discharge.
- Treatment includes management of underlying liver disease and prevention of complications of cirrhosis.
- Despite advances in gastric acid suppression as well as improved endoscopic diagnostic and therapeutic techniques, the mortality rate from UGIB has remained stable.
References
- ↑ Sonnenberg A (2012). "Complications following gastrointestinal bleeding and their impact on outcome and death". Eur J Gastroenterol Hepatol. 24 (4): 388–92. doi:10.1097/MEG.0b013e328350589e. PMID 22233622.
- ↑ Roberts SE, Button LA, Williams JG (2012). "Prognosis following upper gastrointestinal bleeding". PLoS ONE. 7 (12): e49507. doi:10.1371/journal.pone.0049507. PMC 3520969. PMID 23251344.
- ↑ Katschinski B, Logan R, Davies J, Faulkner G, Pearson J, Langman M (1994). "Prognostic factors in upper gastrointestinal bleeding". Dig. Dis. Sci. 39 (4): 706–12. PMID 7908623.
- ↑ Kurien M, Lobo AJ (2015). "Acute upper gastrointestinal bleeding". Clin Med (Lond). 15 (5): 481–5. doi:10.7861/clinmedicine.15-5-481. PMID 26430191.
- ↑ Feinman M, Haut ER (2014). "Upper gastrointestinal bleeding". Surg. Clin. North Am. 94 (1): 43–53. doi:10.1016/j.suc.2013.10.004. PMID 24267496.