• Luminal Gastroenterology
• 31 min
  1. Novel treatments for GI malignancies

  • Prof. Bert H. O'Neil
• 40 min
  2. The spectrum of GERD implications for assessment and management

  • Prof. Eamonn M. M. Quigley
• 54 min
  3. Oro-pharyngeal and esophageal motility and dysmotility

  • Dr. John E. Pandolfino
• 55 min
  4. Eosinophilic esophagitis and other non-reflux esophageal disorders

  • Prof. David Katzka
• 39 min
  5. Disorders of gastric function: gastroparesis and functional dyspepsia 1

  • Dr. Braden Kuo
• 17 min
  6. Disorders of gastric function: gastroparesis and functional dyspepsia 2

  • Dr. Braden Kuo
• 48 min
  7. Acid-peptic diseases of the stomach and duodenum including Helicobacter pylori and NSAIDs

  • Prof. Sheila Crowe
• 48 min
  8. Gastric cancer, gastritis and the role of H. pylori

  • Prof. Anthony Axon
• 48 min
  9. Celiac disease

  • Prof. Ciaran Kelly
• 43 min
  10. IBD for the non-gastroenterologist

  • Prof. Sunanda Kane
• 34 min
  11. The enteric microbiota in health and disease

  • Dr. Francisco Guarner
• 45 min
  12. Colorectal cancer and hereditary colon cancer syndromes

  • Prof. Carol A. Burke
• 39 min
  13. The spectrum of GI ischemia 1

  • Prof. Lawrence J. Brandt
• 31 min
  14. The spectrum of Gl ischemia 2

  • Prof. Lawrence J. Brandt
• 41 min
  15. Constipation and defecation disorders

  • Prof. Satish S. C. Rao
• 40 min
  16. Diverticular disease of the colon

  • Dr. Dale Vimalachandran
• 73 min
  17. Irritable bowel syndrome (IBS)

  • Prof. Eamonn M. M. Quigley
• 27 min
  18. Evidence-based management of non-variceal upper GI bleeding

  • Prof. Joseph J. Sung
• Hepatology
• 32 min
  19. Hepatitis B virus (HBV)

  • Prof. Marco Olivera-Martinez
• 26 min
  20. Hepatitis C - cure of infection

  • Prof. Mark Mailliard
• 46 min
  21. Drug-induced liver injury: importance, epidemiology, and mechanisms of DILI

  • Prof. James H. Lewis
• 26 min
  22. Drug-induced liver injury: risk factors and drug development in DILI

  • Prof. James H. Lewis
• 39 min
  23. Drug-induced liver injury: HDS, diagnosing, treating and preventing DILI

  • Prof. James H. Lewis
• 22 min
  24. Portal hypertension

  • Prof. John Reinus
• 55 min
  25. Portal hypertension: at the bedside

  • Dr. Clara Y. Tow
• 29 min
  26. The management of chronic liver disease, including transplantation 1

  • Prof. Timothy M. McCashland
• 21 min
  27. The management of chronic liver disease, including transplantation 2

  • Prof. Timothy M. McCashland
• 34 min
  28. Hereditary hemochromatosis: what have we learnt from population studies

  • Prof. John K. Olynyk
• 38 min
  29. Immune-mediated liver disease

  • Dr. Jenny Heathcote
• 51 min
  30. Alcoholic liver disease

  • Prof. Michael Lucey
• The Pancreas and Biliary Tree
• 51 min
  31. Acute pancreatitis

  • Prof. Davor Štimac
• 49 min
  32. Chronic pancreatitis

  • Prof. Christopher Forsmark
• 47 min
  33. Pancreatic cancer

  • Prof. Randall Brand
• 20 min
  34. The management of gallstones in relation to laparoscopic cholecystectomy and gallbladder dyskinesia

  • Prof. John Baillie
• Archived Lectures *These may not cover the latest advances in the field
• 52 min
  35. The management of other aspects of chronic liver disease, including transplantation

  • Prof. Timothy M. McCashland
• 38 min
  36. Chronic viral hepatitis B and C

  • Prof. Mark Mailliard
• 41 min
  37. Pancreatic cancer

  • Prof. Randall Brand
• 72 min
  38. Acute viral hepatitis

  • Prof. Geoffrey Dusheiko
• 33 min
  39. Diverticular disease

  • Dr. Charles Knowles
• 57 min
  40. The spectrum of gastrointestinal ischemia: 2010

  • Prof. Lawrence J. Brandt

Printable Handouts

PDF

Navigable Slide Index

1. Introduction
2. Early endoscopy (1)
3. Early endoscopy (2)
4. Endoscopic therapy
5. Adding a second therapy to epinephrine injection
6. Mono or combined therapy?
7. Mono or combined therapy? Risk of rebleeding
8. Mono or combined therapy? Mortality
9. Adding a sclerosant to epinephrine does not help
10. Clips or Thermal?
11. Clips or Thermal? Initial hemostasis
12. Clips or Thermal? Rebleeding
13. Choosing Clips or Thermal
14. Clots: remove or leave it?
15. EndoTx with iv PPI vs. iv PPI alone
16. Clots: remove or leave it? Beneficial patients
17. Clots: remove or leave it? Meta analysis (1)
18. Clots: remove or leave it? Meta analysis (2)
19. PPI before endoscopy?
20. Pre emptive PPI (1)
21. Pre emptive PPI (2)
22. Adjuvant IV PPI?
23. IV PPI cochrane review
24. PUB Study: IV nexium vs. placebo
25. Stigmata of haemorrhage
26. Significantly less rebleeding
27. Rebleeding within 30 days (ITT population)
28. Mortality and surgery within 30 days
29. Benefit irrespective of endoscopic Rx
30. Benefit more Hp positive patients
31. Second look endoscopy reduces rebleeding?
32. Second look and selective retreatment
33. Second look endoscopy
34. Endoscopic retreatment vs. surgery (1)
35. Endoscopic retreatment vs. surgery (2)
36. Outcomes: endoscopic re-treatment and surgery
37. What causes mortality?
38. Proportion of non bleeding related deaths
39. Non-bleeding related mortality (in-hospital death)
40. Bleeding related mortality (in-hospital death)
41. Should we stop aspirin?
42. More recurrent bleeding with aspirin
43. Yet, higher all-cause mortality without aspirin
44. What have we learned? (1)
45. What have we learned? (2)

Topics Covered

• Upper gastrointestinal bleeding is an important medical emergency
• The literature has provided many evidence-based management strategies
• Early endoscopy within 24 hours should be provided
• Injection for active ulcer bleeding should not be used as a monotherapy
• Thermal device (heat probe) is comparable to mechanical device (hemoclips)
• Underlying vessel beneath blood clot should exposed and treated
• Pre-endoscopy use of proton pump inhibitor may reduce need for endoscopic therapy
• Intravenous proton pump inhibitor is an important adjuvant to endoscopic therapy
• Routine second-look endoscopy is not recommended
• Surgery is still providing the ultimate hemostasis in selected cases
• Support of cardiopulmonary conditions is important to reduce mortality
• Anti-platelet agent should be restarted as soon as patient's condition stabilizes

Links

Series:

• Gastroenterology and Hepatology

Categories:

• Clinical Practice

Therapeutic Areas:

• Gastroenterology & Nephrology

Talk Citation

Publication History

• Published on January 5, 2011

Financial Disclosures

• Prof. Joseph J. Sung has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.