Acute upper gastrointestinal bleeding in adults

Quality statements

Statement 1 People with acute upper gastrointestinal bleeding receive a risk assessment using a validated risk score.

Statement 2 People with severe acute upper gastrointestinal bleeding who are haemodynamically unstable are given an endoscopy within 2 hours of optimal resuscitation.

Statement 3 People admitted to hospital with acute upper gastrointestinal bleeding who are haemodynamically stable are given an endoscopy within 24 hours of admission.

Statement 4 People with non-variceal acute upper gastrointestinal bleeding and stigmata of recent haemorrhage are offered endoscopic treatments (combination or a mechanical method).

Statement 5 People with non-variceal acute upper gastrointestinal bleeding who continue to bleed or re-bleed after endoscopic treatment and who are haemodynamically unstable are given interventional radiology treatment.

Statement 6 People with suspected or confirmed variceal acute upper gastrointestinal bleeding are given antibiotic therapy at presentation.

Statement 7 People with acute upper gastrointestinal bleeding from oesophageal varices are given band ligation.

Statement 8 People with acute upper gastrointestinal bleeding from gastric varices are given an endoscopic injection of N‑butyl‑2‑cyanoacrylate.

Statement 9 People with uncontrolled acute upper gastrointestinal bleeding from varices are given transjugular intrahepatic portosystemic shunts (TIPS).

Statement 10 People with acute upper gastrointestinal bleeding who take aspirin for secondary prevention of vascular events and in whom haemostasis has been achieved are advised to continue on low-dose aspirin.