This document discusses gastrointestinal (GI) bleeding and differentiates between upper GI (UGI) and lower GI sources. UGI bleeding is considered a medical emergency requiring ICU care and blood transfusions. Common causes of UGI bleeding include esophageal tears, esophagitis, and gastric ulcers. Lower GI bleeding is usually not life-threatening but the patient's underlying condition is important. Causes of lower GI bleeding include diverticulitis, hemorrhoids, and cancer. Diagnosis involves endoscopy, colonoscopy, and angiography, with treatment depending on the identified source.

1. GI Bleeding
Steven Podnos MD

2. UGI vs Lower GI source
• Melena
• Hematochezia
• History?

3. Lower GI Bleeding
• Diverticulitis
• Fissure/Hemmorhoids
• Cancer
• Rarely life threatening-underlying clinical
status important

4. Lower GI Bleeding-Rx
• BE
• Colonoscopy
• Angiography
• Surgery

5. UGI Bleeding
• A Medical Emergency
• Think Esophagus, Stomach, Duodenum
• ICU care, Blood available, IV access

6. Esophageal Sources
• Mallory Weiss Tear-supportive care
• Esophagitis-anti-acid Rx, supportive
• Varices-endoscopy, Somatostatin, anti-acid
Rx, Shunt, Blakemore tube

7. Stomach
• Gastritis-endoscopy, anti-acid Rx, supportive
• Ulcer-endoscopy, anti-acid Rx, biopsy, surgery

8. Duodenum
• Ulcer-anti acid Rx, endoscopy, H. Pylori

9. Small Bowel Bleeding
• Rarely acutely dangerous
• AVM
• Special endoscopy, capsule camera,
• Angiography