Dr. Hiwa Abubakir and Dr. Mohamed Alshekhani discuss the management of nonvariceal gastrointestinal bleeding. They recommend endoscopy within 24 hours, or earlier for high-risk patients, to identify and treat the bleeding source. A variety of endoscopic tools can be used for hemostasis, including injection of adrenaline combined with clips, bands, electrocautery, or laser coagulation. Newer tools like over-the-scope clips are best for high-risk or recurrent bleeders. Doppler probes help ensure complete vessel occlusion. Additional prothrombotic agents or interventions may be needed in some cases.

1. Dr. Hiwa Abubakir
Dr.Mohamed Alshekhani
Gastroenterologist
NVGI Bleeding

2. NVUGIB managemt: when Endoscopy
• Generally within 24 hours.
• But earlier in subsets of patients.

5. Endoscopic intervention tools:
• Classical: Dual endoscopic hemostatic strategy.
• NS-Adrenaline + other hemostatic tool(resolution
clip,band,electrocoag,laser coag,APC,scleosants).
• New tools: mainly for high risk bleeder or recurrent bleeding after 1st
endoscopic hemostasis:
• Over the scope clip(OTSC).
• Hemostatic spary: for tumor bleeding and for difficult to access sites.
• Coagrassper hemostatic forceps( used for ESD bleedings)
• Through the scope Doppler probe to ensure bleeding vessels obliteration.

8. • May need prothrombotic agents liKe activated F7 or new endoscopic
intervention tool as OTSC