ABSTRACT
Upper gastrointestinal bleeding (UGIB) accounts for over 300,000 hospital admissions per year in the United States and is a common cause for admission to the intensive care unit. Optimal outcomes are dependent upon prevention, rapid identification of the etiology of the hemorrhage, and the subsequent implementation of appropriate pharmacologic and procedural therapies. The majority of episodes of UGIB are due to nonvariceal causes, with ulcer disease accounting for the majority of these nonvariceal cases. Aside from ulcer disease, other etiologies of UGI bleeding include varices, Mallory-Weiss syndrome, vascular lesions, and inflammatory states of the upper GI tract. Octreotide, a hormone analog of somatostatin that alters GI hormone signaling, is the main vasoactive drug used to treat variceal bleeding. It decreases gastric and pancreatic secretions and alters splanchnic blood flow. Endoscopy is beneficial in UGI bleeds because it can be simultaneously diagnostic and therapeutic, particularly in patients with no prior history of bleeding.
