PHIL 2015 Chapter Notes - Chapter 3.3: Gastric Antral Vascular Ectasia, Upper Gastrointestinal Bleeding, Gastrointestinal Bleeding
23 May 2020
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Peptic ulcer disease and gerd: gastrointestinal bleeding, 85-90% is from upper gi tract, 10-15% is from lower gi tract. Low dose asa combined with coxib has a similar rate of pud as nsaids alone (16. 1% vs 17. 1%: management of pud: Phm143: ppi efficacy, acid inhibits platelet function which is required for clotting, ppis reduce acid secretion by blocking the final step in acid production through inhibition of the h+/k+ atpase in parietal cells. The high ph created promotes stable clot formation required for hemostasis: safe, effective and reduces risk of re-bleeding and need for surgery. Iv ppi: used for high risk lesions, reduced re-bleeding and need for surgery, no change in mortality. Intermittent dosing is of minimal benefit: endoscopy, 1. Prognosis id risk of lesion: risk of rebleed and mortality, greater when ulcer size > 1cm, also dependent on ulcer base characteristics, 3.
