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haematochezia

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3.5.1 - Gastrointestinal Haemorrhage
from Section 3.5 - Acute Gastrointestinal Failure
- By Megan Fahy, Liza Keating
Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
Book:

Intensive Care Medicine

Published online:

27 July 2023

Print publication:

01 December 2021, pp 205-207
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Summary

Key Learning Points
1. In suspected variceal bleeding, terlipressin and prophylactic antibiotics should be administered at presentation.
2. In upper gastrointestinal bleeding, a restrictive approach to blood transfusion reduces rebleeding rates and mortality.
3. Following a non-variceal upper gastrointestinal bleed in those taking aspirin for secondary prevention of vascular events, aspirin should be restarted when haemostasis is achieved.
4. Haematochezia is caused by an upper gastrointestinal bleed in approximately 10 per cent of presentations.
5. Early initiation of enteral feeding is effective in preventing bleeding from stress ulcer in critically unwell adults.