Episode 125: Upper GI Bleeding Evidence and Controversies Part 1

This podcast addresses the diagnosis and management of acute upper GI bleeding, which is defined as bleeding originating from the esophagus, stomach, or proximal small intestine. It highlights controversies surrounding nasogastric (NG) tube lavage, concluding that it should not be routinely used to determine the source of bleeding. The discussion emphasizes a restrictive transfusion strategy, targeting a hemoglobin level of 7 g/dL for stable patients and 8 g/dL for those with cardiovascular disease. The podcast also covers the use of PPIs, noting their potential benefit in patients with confirmed peptic ulcer disease post-endoscopy, and recommends erythromycin before endoscopy to improve visualization. It advises against routine TXA use and suggests antibiotics for upper GI bleeding in patients with cirrhosis.