LAUSR

A upper gastrointestinal bleeding (UGIB) is a common medical emergency in the United States that is associated with significant morbidity and mortality, frequent hospital admissions, and costs of more than $2 billion annually to the health care system.1 Upper gastrointestinal hemorrhage is defined as bleeding from any enteric source proximal to the ligament of Treitz. Upper gastrointestinal bleeding is approximately 5 times more likely to occur than lower gastrointestinal bleeding.2 Male patients and elderly patients tend to be more commonly affected.2 Initial management of clinically significant acute UGIB includes volume resuscitation to restore hemodynamic stability, diagnostic studies to identify the source and severity of bleeding, and pharmacological interventions to increase gastric pH and assist with hemostasis. Data on patients with UGIB from 1993 to 2000 showed a decreasing incidence of the condition, suggesting that prevention strategies are improving. Despite advances in therapeutic management of UGIB, however, the risk of rebleeding and mortality rates have remained unchanged.3 In this article, we discuss risk factors, initial evaluation and restoration of intravascular volume, and pharmacological management of acute UGIB.