#355 GI Bleed with Dr. Tanvi Dhere

In this episode of The Curbsiders, hosts Monee Amin and Meredith Trubitt interview Dr. Tanvi Dhere about managing and diagnosing upper and lower GI bleeds. Dr. Dhere shares insights on initial assessments, the limited utility of stool guaiac tests, risk stratification tools like the Glasgow Blatchford score, and the importance of IV PPIs. The discussion covers endoscopy timing, the use of erythromycin to improve visualization, transfusion thresholds, and H. pylori testing. For lower GI bleeds, they discuss colonoscopy versus imaging options like CTA or tagged RBC scans, surgical interventions, capsule endoscopy, and considerations for anticoagulation and antiplatelet therapy. Dr. Dhere emphasizes a multidisciplinary approach and tailored patient management.

Outlines

Part 1: Introduction, Initial Assessment

Part 2: Upper GI Bleed Management

Part 3: Lower GI Bleed Diagnosis

Part 4: Advanced Interventions, Conclusion

Sign in to continue reading, translating and more.

Open full episode in Podwise

The Curbsiders Internal Medicine Podcast

Part 1: Introduction, Initial Assessment

Introduction to GI Bleeds and Guest Introduction

Picks of the Week and Initial GI Bleed Case Presentation

Differential Diagnosis and Additional History for Upper GI Bleed

Relevance of Guaiac Stool Testing and Risk Stratification for GI Bleeds

Part 2: Upper GI Bleed Management

Initial Management Steps for Upper GI Bleed

The Role of Erythromycin and Managing Unstable GI Bleeds

Transfusion Guidelines and H. pylori Testing

Post-Procedure Management and Upper GI Bleed Summary

Part 3: Lower GI Bleed Diagnosis

Introduction to Lower GI Bleed Case and Diagnostic Considerations

CTA Scans, Tagged Red Cell Scans, and Angiography for Lower GI Bleeds

Part 4: Advanced Interventions, Conclusion

Medical and Surgical Management of Diverticular Bleeds and Capsule Endoscopy

Anticoagulation Management, Key Takeaways, and Episode Conclusion

#355 GI Bleed with Dr. Tanvi Dhere

The Curbsiders Internal Medicine Podcast

Part 1: Introduction, Initial Assessment

00:04Introduction to GI Bleeds and Guest Introduction

Introduction to GI Bleeds and Guest Introduction

06:40Picks of the Week and Initial GI Bleed Case Presentation

Picks of the Week and Initial GI Bleed Case Presentation

12:13Differential Diagnosis and Additional History for Upper GI Bleed

Differential Diagnosis and Additional History for Upper GI Bleed

17:07Relevance of Guaiac Stool Testing and Risk Stratification for GI Bleeds

Relevance of Guaiac Stool Testing and Risk Stratification for GI Bleeds

Part 2: Upper GI Bleed Management

22:22Initial Management Steps for Upper GI Bleed

Initial Management Steps for Upper GI Bleed

29:23The Role of Erythromycin and Managing Unstable GI Bleeds

The Role of Erythromycin and Managing Unstable GI Bleeds

35:13Transfusion Guidelines and H. pylori Testing

Transfusion Guidelines and H. pylori Testing

40:35Post-Procedure Management and Upper GI Bleed Summary

Post-Procedure Management and Upper GI Bleed Summary

Part 3: Lower GI Bleed Diagnosis

45:31Introduction to Lower GI Bleed Case and Diagnostic Considerations

Introduction to Lower GI Bleed Case and Diagnostic Considerations

52:05CTA Scans, Tagged Red Cell Scans, and Angiography for Lower GI Bleeds

CTA Scans, Tagged Red Cell Scans, and Angiography for Lower GI Bleeds

Part 4: Advanced Interventions, Conclusion

57:01Medical and Surgical Management of Diverticular Bleeds and Capsule Endoscopy

Medical and Surgical Management of Diverticular Bleeds and Capsule Endoscopy

1:02:25Anticoagulation Management, Key Takeaways, and Episode Conclusion

Anticoagulation Management, Key Takeaways, and Episode Conclusion