Why do we give PPI for GI bleed?

PPIs reduce gastric acid secretion for up to 36 hours,41 thereby promoting healing of ulcers and erosions as well as stabilizing thrombi and decreasing rates of GI bleeding in patients on DAPT.

Do you use PPI for lower GI bleed?

Core tip: Proton pump inhibitors (PPIs) reduce the risk of upper, but not lower gastrointestinal bleeding (LGB) in patients receiving nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin.

What medication is used for a GI bleed?

If you have an upper GI bleed, you might be given an IV drug known as a proton pump inhibitor (PPI) to suppress stomach acid production. Once the source of the bleeding is identified, your doctor will determine whether you need to continue taking a PPI .

What is the first line of treatment for upper GI bleeding?

Acid suppression — Patients admitted to the hospital with acute upper GI bleeding are typically treated with a proton pump inhibitor (PPI). The optimal approach to PPI administration prior to endoscopy is unclear. Options include giving an IV PPI every 12 hours or starting a continuous infusion.

What is upper GI bleeding?

Upper GI bleeding (UGIB) is defined as bleeding derived from a source proximal to the ligament of Treitz. The incidence of UGIB is approximately 100 cases per 100,000 population per year.

What are the causes of upper GI bleeding?

Potential causes of bleeding in the upper GI tract include:

Bleeding peptic ulcers. Peptic, or stomach, ulcers may be due to a Helicobacter pylori infection or overuse of nonsteroidal anti-inflammatory drugs (NSAIDs).
Varices.
Growths.
Esophagitis.
Injury or tear.
Surgery.
Diverticulitis.
Hemorrhoid.

What is the difference between upper GI bleeding and lower GI bleeding?

Upper GI bleeding: The upper GI tract includes the esophagus (the tube from the mouth to the stomach), stomach, and first part of the small intestine. Lower GI bleeding: The lower GI tract includes much of the small intestine, large intestine or bowels, rectum, and anus.

How can you tell the difference between upper and lower gastrointestinal bleeding?

Upper GI bleeding includes hemorrhage originating from the esophagus to the ligament of Treitz, at the duodenojejunal flexure[13]. Lower GI bleeding is defined as bleeding that originates from a site distal to the ligament of Treitz[14].

Which medications increase the risk for upper gastrointestinal GI bleeding?

The risk for upper gastrointestinal (UGI) bleeding associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, selective serotonin reuptake inhibitors (SSRIs), and antiplatelet drugs is well known.

What is the difference between upper and lower GI bleed?

How do PPIs prevent bleeding?

Infusion with proton pump inhibitors (PPIs) prevents recurrent bleeding after successful endoscopic therapy. A gastric acidic environment of less than pH 5.4 alters coagulation function and activates pepsin to disaggregate platelet plugs. Gastric acid is secreted by H+, K+-ATPase, naming the proton pump.

When is PPI indicated in the treatment of upper GI bleeding?

For upper GI bleeding, it is now common practice to initiate intravenous PPI therapy once the hemodynamic status has been assessed and any necessary resuscitative measures have been implemented.

What is the role of PPIs in the treatment of aspirin-associated bleeding?

Conversely, PPIs play an important role in the prevention of upper GI bleeding in high-risk patients taking NSAIDs, aspirin, or DAPT. Such patients are often elderly and with comorbidity; however, PPI treatment should be continued for as long as is appropriate even though patients may not experience any upper GI symptoms.

How common is undifferentiated upper GI bleed without a peptic ulcer?

Since 37-45% of undifferentiated upper GI bleed is not from a peptic ulcer 1, 2 patients can be subject to unnecessary medications and cost. Four randomized control trials comprising of almost 1500 patients were included in the analysis.

Does peripheral intestine injection before endoscopy improve mortality in upper GI bleeding?

We found no evidence that initiation of PPI treatment prior to endoscopy had an effect on the 30 day all‐cause mortality in unselected patients with acute upper gastrointestinal bleeding.