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Advances in care across pre\u2010endoscopic, endoscopic and post\u2010endoscopic phases have led to improvements in clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To provide a detailed, evidence\u2010based update on major aspects of care across pre\u2010endoscopic, endoscopic and post\u2010endoscopic phases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a structured bibliographic database search for each topic. If a recent high\u2010quality meta\u2010analysis was not available, we performed a meta\u2010analysis with random effects methods and odds ratios with 95% confidence intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pre\u2010endoscopic management of UGIB includes risk stratification, a restrictive red blood cell transfusion policy unless the patient has cardiovascular disease, and pharmacologic therapy with erythromycin and a proton pump inhibitor. Patients with cirrhosis should be treated with prophylactic antibiotics and vasoactive medications. Tranexamic acid should not be used. Endoscopic management of UGIB depends on the aetiology. For peptic ulcer disease (PUD) with high\u2010risk stigmata, endoscopic therapy, including over\u2010the\u2010scope clips (OTSCs) and TC\u2010325 powder spray, should be performed. For variceal bleeding, treatment should be customised by severity and anatomic location. Post\u2010endoscopic management includes early enteral feeding for all UGIB patients. For high\u2010risk PUD, PPI should be continued for 72\u2009h, and rebleeding should initially be evaluated with a repeat endoscopy. For variceal bleeding, high\u2010risk patients or those with further bleeding, a transjugular intrahepatic portosystemic shunt can be considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Management of acute UGIB should include treatment plans for pre\u2010endoscopic, endoscopic and post\u2010endoscopic phases of care, and customise treatment decisions based on aetiology and severity of bleeding.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17949","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T13:04:34Z","timestamp":1711112674000},"page":"1062-1081","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Review article: Upper gastrointestinal bleeding \u2013 review of current evidence and implications for management"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8226-1842","authenticated-orcid":false,"given":"Dennis L.","family":"Shung","sequence":"first","affiliation":[{"name":"Yale School of Medicine New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4296-7901","authenticated-orcid":false,"given":"Loren","family":"Laine","sequence":"additional","affiliation":[{"name":"Yale School of Medicine New Haven Connecticut USA"},{"name":"West Haven Veterans Affairs Medical Center West Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17238"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2014-100453"},{"issue":"8","key":"e_1_2_10_4_1","first-page":"1544","article-title":"Timing of endoscopy for acute upper gastrointestinal bleeding: a territory\u2010wide cohort study","volume":"71","author":"Guo CLT","year":"2022","journal-title":"Gut"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001627"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001245"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/M7319\u20101795"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2018-316276"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1369-5274"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61769-9"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgast-2018-000225"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.09.009"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.38.3.316"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.06.024"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2019-320002"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2022.01.024"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000632"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjhci-2020-100245"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-88226-3"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgast-2020-000479"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.12.022"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211801"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61999-1"},{"issue":"1","key":"e_1_2_10_24_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.4103\/sjg.SJG_152_20","article-title":"Restrictive versus liberal transfusion strategy in upper gastrointestinal bleeding: a randomized controlled trial","volume":"27","author":"Kola G","year":"2021","journal-title":"Saudi J Gastroenterol"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.0135"},{"issue":"3","key":"e_1_2_10_26_1","first-page":"312","article-title":"Pre\u2010endoscopic erythromycin administration in upper gastrointestinal bleeding: an updated meta\u2010analysis and systematic review","volume":"29","author":"Rahman R","year":"2016","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_10_27_1","doi-asserted-by":"crossref","unstructured":"VimonsuntirungsriT ThungsukR NopjaroonsriP FaknakN PittayanonR.The efficacy of metoclopramide of gastric visualization by endoscopy in patients with active upper gastrointestinal bleeding: double\u2010blind randomized controlled trial. 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