← Back to guidelines
Cardiology617 papers

Recurrent gastrointestinal bleeding

Last edited: 4/23/2026

Overview

Recurrent gastrointestinal bleeding (GIB) refers to repeated episodes of bleeding originating from the gastrointestinal tract, often necessitating comprehensive diagnostic evaluation and tailored management strategies to identify and address underlying causes.

Diagnosis

  • Clinical Presentation: Symptoms include hematochezia, melena, or iron deficiency anemia 513.
  • Initial Tests: Complete blood count, coagulation profile, and stool guaiac test 310.
  • Advanced Imaging: CT angiography, video capsule endoscopy, and device-assisted enteroscopy for obscure bleeding 122425.
  • Endoscopic Evaluation: Upper and lower endoscopy to identify sources such as varices, angiodysplasias, or vascular malformations 122444.
  • Management

  • First-Line Treatments:
  • - Hemodynamic Stabilization: Fluid resuscitation, blood transfusion as needed 918. - Endoscopic Intervention: Hemostasis techniques (e.g., endoscopic band ligation, sclerotherapy, clipping) for identified sources 1424.
  • Adjunctive Treatments:
  • - Anticoagulant/Antiplatelet Management: Consultation with hematology for bridging therapy or temporary interruption 317. - Proton Pump Inhibitors (PPIs): For peptic ulcer disease to promote ulcer healing 10. - Octreotide: For refractory bleeding, particularly in patients with vascular malformations or pancreaticobiliary disorders 2233.

    Special Populations

  • Pediatrics: Structured sedation protocols (e.g., propofol with or without midazolam) and specialized training for pediatric endoscopists 111.
  • Elderly: Increased risk of complications; careful assessment of comorbidities and bleeding risk 948.
  • Comorbidities: Patients on antithrombotic agents require tailored periendoscopic management to balance bleeding risk and thromboembolic risk 31740.
  • Key Recommendations

  • Initial Assessment and Hemodynamic Support: Prioritize hemodynamic stabilization and blood transfusion for acute bleeding episodes (Evidence: Strong 918).
  • Endoscopic Evaluation and Intervention: Perform thorough endoscopic evaluation to identify and treat the source of bleeding (Evidence: Strong 1224).
  • Management of Antithrombotic Therapy: Consult hematology for individualized management of antiplatelet and anticoagulant therapy around endoscopic procedures (Evidence: Moderate 317).
  • Use of PPIs in Peptic Ulcer Disease: Administer proton pump inhibitors to promote ulcer healing in patients with peptic ulcer bleeding (Evidence: Moderate 10).
  • Consider Octreotide for Refractory Bleeding: Use octreotide in cases of refractory bleeding, especially in complex vascular lesions (Evidence: Moderate 2233).
  • References

    Showing 100 most recent of 374 indexed papers.

    1 Chen Q, Wang J, Hu C. Safety and Efficacy of Different Sedation Regimens in Pediatric Diagnostic Gastroscopy: A Retrospective Controlled Study. Clinical pediatrics 2026. link 2 Maeda N, Higashimori A, Okamura H, Fujimoto K, Kobayashi Y, Nakata A et al.. Propofol Sedation with a Target-Controlled Infusion Pump and Bispectral Index Monitoring System in Older Patients Undergoing Antegrade Balloon-Assisted Enteroscopy. Digestive diseases and sciences 2026. link 3 Riu Pons F, Vilalta N, Ibáñez-Sanz G, Quintana-Carbó S, Calvo A, Uchima H et al.. Antithrombotics drugs in Gastrointestinal Endoscopy. Position Statment of the Catalan Society of Gastroenterology. Gastroenterologia y hepatologia 2026. link 4 Lima Capela T, Gonçalves JC, Ferreira AI, Macedo Silva V, Macedo C, Arieira C et al.. Assessing the Impact of a Structured Capsule Endoscopy Training Program Using a New Validated Assessment Tool. Journal of gastroenterology and hepatology 2025. link 5 Jonnagaddala J, Ahmed S, Chayeb JME. Lower gastrointestinal bleeding from colonic varices of unknown origin. Clinics and research in hepatology and gastroenterology 2025. link 6 Wang X, Luo M, Li W, Zhou Y. Drug-Induced Spontaneous Intramural Hematoma of the Gastrointestinal Tract: A Real-World Pharmacovigilance Analysis. Journal of cardiovascular pharmacology 2025. link 7 Yomogida D, Kuwano H, Miyakoshi T, Mizuta S, Horikawa S, Koshida Y et al.. Severe Duodenal Bleeding with Heterotaxy Syndrome Controlled by Combined Hemostatic Strategies. Internal medicine (Tokyo, Japan) 2025. link 8 Ono Y, Hatta W, Tarasawa K, Ogata Y, Abe H, Sato I et al.. Optimal direct oral anticoagulant for upper gastrointestinal endoscopic submucosal dissection. Journal of gastroenterology 2025. link 9 MacLaren R, Dionne JC, Granholm A, Alhazzani W, Szumita PM, Olsen K et al.. Society of Critical Care Medicine and American Society of Health-System Pharmacists Guideline for the Prevention of Stress-Related Gastrointestinal Bleeding in Critically Ill Adults. Critical care medicine 2024. link 10 Rosenberg K. Lower Risk of Upper GI Bleeding with Pantoprazole in Adults Receiving Mechanical Ventilation. The American journal of nursing 2024. link 11 Barakat MT, Bass D, Goyal A, Fink C, Mostamand S, Gugig R. Pediatric advanced complex endoscopy team enhances endoscopy quality and provider satisfaction. Journal of pediatric gastroenterology and nutrition 2024. link 12 Sengupta N, Kastenberg DM, Bruining DH, Latorre M, Leighton JA, Brook OR et al.. The Role of Imaging for Gastrointestinal Bleeding: Consensus Recommendations From the American College of Gastroenterology and Society of Abdominal Radiology. The American journal of gastroenterology 2024. link 13 Long B, Gottlieb M. Emergency medicine updates: Lower gastrointestinal bleeding. The American journal of emergency medicine 2024. link 14 Meram E, Russell E, Ozkan O, Kleedehn M. Variceal and Nonvariceal Upper Gastrointestinal Bleeding Refractory to Endoscopic Management: Indications and Role of Interventional Radiology. Gastrointestinal endoscopy clinics of North America 2024. link 15 Sengupta N, Feuerstein JD, Jairath V, Shergill AK, Strate LL, Wong RJ et al.. Management of Patients With Acute Lower Gastrointestinal Bleeding: An Updated ACG Guideline. The American journal of gastroenterology 2023. link 16 McSorley B, Chugh A, Abazi T, Lerner D, Jobe S, Pan AY et al.. Implementation of a Bleeding Risk Screening Tool and Hematology Referral Process Prior to Pediatric Endoscopy. Journal of pediatric gastroenterology and nutrition 2023. link 17 Arora A, Kumar A, Anand AC, Kumar A, Yadav A, Bhagwat A et al.. Position statement from the Indian Society of Gastroenterology, Cardiological Society of India, Indian Academy of Neurology and Vascular Society of India on gastrointestinal bleeding and endoscopic procedures in patients on antiplatelet and/or anticoagulant therapy. Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology 2023. link 18 Asiedu JO, Thomas AJ, Cruz NC, Nicholson R, Resar LMS, Khashab M et al.. Management and clinical outcomes for patients with gastrointestinal bleeding who decline transfusion. PloS one 2023. link 19 Dong SA, Guo Y, Liu SS, Wu LL, Wu LN, Song K et al.. A randomized, controlled clinical trial comparing remimazolam to propofol when combined with alfentanil for sedation during ERCP procedures. Journal of clinical anesthesia 2023. link 20 Füssel LM, Müller-Wille R, Dinkhauser P, Schauer W, Hofer H. Treatment of colonic varices and gastrointestinal bleeding by recanalization and stenting of splenic-vein-thrombosis: A case report and literature review. World journal of gastroenterology 2023. link 21 Shuttleworth P, Baker J, Clark E. Under-reporting of gastrointestinal bleeding associated with anticoagulant use using the UK Yellow Card Scheme. International journal of clinical pharmacy 2023. link 22 Ingason AB, Hreinsson JP, Agustsson AS, Lund SH, Rumba E, Palsson DA et al.. Warfarin Is Associated With Higher Rates of Upper But Not Lower Gastrointestinal Bleeding Compared with Direct Oral Anticoagulants: A Population-Based Propensity-Weighted Cohort Study. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 2023. link 23 Hamada Y, Umeda Y, Ikenoyama Y, Shigefuku A, Yukimoto H, Nakamura M et al.. Obscure Gastrointestinal Bleeding Caused by a Small Intestinal Lymphatic-venous Malformation: A Case Report with a Literature Review. Internal medicine (Tokyo, Japan) 2023. link 24 Abraham NS, Barkun AN, Sauer BG, Douketis J, Laine L, Noseworthy PA et al.. American College of Gastroenterology-Canadian Association of Gastroenterology Clinical Practice Guideline: Management of Anticoagulants and Antiplatelets During Acute Gastrointestinal Bleeding and the Periendoscopic Period. The American journal of gastroenterology 2022. link 25 Hanscom M, Stead C, Feldman H, Marya NB, Cave D. Video Capsule Endoscopy and Device-Assisted Enteroscopy. Digestive diseases and sciences 2022. link 26 Chi F, Lan Y, Jiang L. A Rare Cause of Recurrent Melena: Haemangioma of the Small Intestine. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP 2022. link 27 Kudu E, Danış F. The Evolution of Gastrointestinal Bleeding: A Holistic Investigation of Global Outputs with Bibliometric Analysis. The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology 2022. link 28 Radadiya D, Devani K, Rockey DC. The impact of red blood cell transfusion practices on inpatient mortality in variceal and non-variceal gastrointestinal bleeding patients: a 20-year US nationwide retrospective analysis. Alimentary pharmacology & therapeutics 2022. link 29 Raţiu I, Lupuşoru R, Popescu A, Sporea I, Goldiş A, Dănilă M et al.. Acute gastrointestinal bleeding: A comparison between variceal and nonvariceal gastrointestinal bleeding. Medicine 2022. link 30 Ruiz J, López-Vinardell L, Juanes A, Riera-Magallon A, Puig M, Mangues MA. Risk factors for emergency department revisit in elderly patients with gastrointestinal bleeding secondary to anticoagulant therapy. European journal of hospital pharmacy : science and practice 2022. link 31 Siebenhüner K, Blaser J, Nowak A, Cheetham M, Mueller BU, Battegay E et al.. Comorbidities Associated with Worse Outcomes Among Inpatients Admitted for Acute Gastrointestinal Bleeding. Digestive diseases and sciences 2022. link 32 Ágústsson AS, Ingason AB, Rumba E, Pálsson D, Reynisson IE, Hreinsson JP et al.. Causes of gastrointestinal bleeding in oral anticoagulant users compared to non-users in a population-based study. Scandinavian journal of gastroenterology 2022. link 33 Veitch AM, Radaelli F, Alikhan R, Dumonceau JM, Eaton D, Jerrome J et al.. Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update. Gut 2021. link 34 Triantafyllou K, Gkolfakis P, Gralnek IM, Oakland K, Manes G, Radaelli F et al.. Diagnosis and management of acute lower gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2021. link 35 Veitch AM, Radaelli F, Alikhan R, Dumonceau JM, Eaton D, Jerrome J et al.. Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update. Endoscopy 2021. link 36 Piccin A, Spizzo G, Popovski MA, Russo FP, Armanaschi L, Vecchiato C et al.. Transfusion-associated circulatory overload in gastroenterology. Blood transfusion = Trasfusione del sangue 2021. link 37 Bor R, Szántó KJ, Fábián A, Farkas K, Szűcs M, Rutka M et al.. Effect of COVID-19 pandemic on workflows and infection prevention strategies of endoscopy units in Hungary: a cross-sectional survey. BMC gastroenterology 2021. link 38 Zhang M, Liu D, Wang Q, Geng X, Hou Q, Gu G et al.. Gastrointestinal bleeding in patients admitted to cardiology: risk factors and a new risk score. Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese 2021. link 39 Chue KM, Boey JY, Ng BSM, Teh JL, Kim G, Shabbir A et al.. Admission discipline and timing of admission may influence outcomes for gastrointestinal bleeding patients. ANZ journal of surgery 2021. link 40 Paciullo F, Fierro T, Calcinaro F, Zucca Giucca G, Gresele P, Bury L. Long-term treatment with thalidomide for severe recurrent hemorrhage from intestinal angiodysplasia in Glanzmann Thrombasthenia. Platelets 2021. link 41 Arieira C, Magalhães R, Dias de Castro F, Boal Carvalho P, Rosa B, Moreira MJ et al.. Small Bowel Angioectasias Rebleeding and the Identification of Higher Risk Patients. Digestive diseases and sciences 2021. link 42 Wilson TJ, Baran DA, Herre JM, Cameron CM, Yehya A, Ingemi AI. Gastrointestinal Bleeding Rates in Left Ventricular Assist Device Population Reduced with Octreotide Utilization. ASAIO journal (American Society for Artificial Internal Organs : 1992) 2021. link 43 Sue-Chue-Lam C, Castelo M, Baxter NN. Factors Associated With Mortality After Emergency Colectomy for Acute Lower Gastrointestinal Bleeding. JAMA surgery 2020. link 44 Soetikno R, Asokkumar R, Chin YK, Salazar E, Nguyen-Vu T, Sanduleanu S et al.. Rapid and Safe Crossing of the Chasm: Application of a Flipped Learning Framework for the Clipping Over the Scope Technique. Gastrointestinal endoscopy clinics of North America 2020. link 45 Pourmand K, Nagula S, Keefer L, Shah B. Faculty Development Workshop for Endoscopic Teaching Techniques. MedEdPORTAL : the journal of teaching and learning resources 2020. link 46 Becq A, Jais B, Fron C, Rotkopf H, Perrod G, Rudler M et al.. Drastic decrease of urgent endoscopies outside regular working hours during the Covid-19 pandemic in the paris area. Clinics and research in hepatology and gastroenterology 2020. link 47 Ogawa T, Tomoda T, Kato H, Akimoto Y, Tanaka S, Okada H. Propofol sedation with a target-controlled infusion pump in elderly patients undergoing ERCP. Gastrointestinal endoscopy 2020. link 48 Fukuda S, Shimodaira Y, Watanabe K, Takahashi S, Sugawara K, Suzuki Y et al.. Risks for Rebleeding and In-Hospital Mortality after Gastrointestinal Bleeding in a Tertiary Referral Center in Japan. Digestion 2020. link 49 Sokoro A, Shafer LA, Darr M, Singh H. Utility of fecal immunochemical test vs guaiac fecal occult blood test for assessment of gastrointestinal bleed in hospitalized patients. Clinica chimica acta; international journal of clinical chemistry 2020. link 50 Tomlin A, Woods DJ, Lambie A, Eskildsen L, Ng J, Tilyard M. Ethnic inequality in non-steroidal anti-inflammatory drug-associated harm in New Zealand: A national population-based cohort study. Pharmacoepidemiology and drug safety 2020. link 51 Axelrad JE, Faye AS, Pinsino A, Thanataveerat A, Cagliostro B, Pineda MFT et al.. Endoscopic Algorithm for Management of Gastrointestinal Bleeding in Patients With Continuous Flow LVADs: A Prospective Validation Study. Journal of cardiac failure 2020. link 52 Lee DS, Ahn JY, Lee GH. A Newly Designed 3-Dimensional Printer-Based Gastric Hemostasis Simulator with Two Modules for Endoscopic Trainees (with Video). Gut and liver 2019. link 53 Cohen J, Desilets DJ, Hwang JH, Kyanam Kabir Baig KR, Leung FW, Maranki JL et al.. Gastrointestinal Endoscopy Editorial Board top 10 topics: advances in GI endoscopy in 2018. Gastrointestinal endoscopy 2019. link 54 Oakland K, Chadwick G, East JE, Guy R, Humphries A, Jairath V et al.. Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology. Gut 2019. link 55 Xavier SA, Machado FJ, Magalhães JT, Cotter JB. Acute lower gastrointestinal bleeding: are STRATE and BLEED scores valid in clinical practice?. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 2019. link 56 Heiberger CJ, Mehta TI, Yim D. Jejunal varices: an unconsidered cause of recurrent gastrointestinal haemorrhage. BMJ case reports 2019. link 57 Augustin AM, Fluck F, Bley T, Kickuth R. Endovascular Therapy of Gastrointestinal Bleeding. RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 2019. link 58 Pannatier M, Duran R, Denys A, Meuli R, Zingg T, Schmidt S. Characteristics of patients treated for active lower gastrointestinal bleeding detected by CT angiography: Interventional radiology versus surgery. European journal of radiology 2019. link 59 McDonald DD. Predictors of gastrointestinal bleeding in older persons taking nonsteroidal anti-inflammatory drugs: Results from the FDA adverse events reporting system. Journal of the American Association of Nurse Practitioners 2019. link 60 Kitamoto H, Fukushima M, Inokuma T. Chronic GI bleeding in a middle-aged woman. Gut 2019. link 61 Radaelli F, Fuccio L, Paggi S, Hassan C, Repici A, Rondonotti E et al.. Periendoscopic management of direct oral anticoagulants: a prospective cohort study. Gut 2019. link 62 Wiemer HM, Butler MB, Froese PC, Lapierre A, Carriere C, Etsell GR et al.. Procedural sedation by advanced care paramedics for emergency gastrointestinal endoscopy. CJEM 2019. link 63 Nakajima-Doi S, Seguchi O, Shintani Y, Fujita T, Fukushima S, Matsumoto Y et al.. Experience of the use of octreotide for refractory gastrointestinal bleeding in a patient with Jarvik2000. Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs 2019. link 64 Chan FKL, Goh KL, Reddy N, Fujimoto K, Ho KY, Hokimoto S et al.. Management of patients on antithrombotic agents undergoing emergency and elective endoscopy: joint Asian Pacific Association of Gastroenterology (APAGE) and Asian Pacific Society for Digestive Endoscopy (APSDE) practice guidelines. Gut 2018. link 65 Newman DK. G6b-B: the "Y's" and wherefores. Blood 2018. link 66 Thomson M. There Is No Excuse for Mortality Due to Lack of Competency and Training of Paediatric Endoscopists in Gastrointestinal Bleeding Therapy in 2018. Journal of pediatric gastroenterology and nutrition 2018. link 67 Sangal RB, Conlon LW. Rodenticide Causing Lower Gastrointestinal Bleeding: Resident Simulation. MedEdPORTAL : the journal of teaching and learning resources 2018. link 68 Oakland K, Guy R, Uberoi R, Hogg R, Mortensen N, Murphy MF et al.. Acute lower GI bleeding in the UK: patient characteristics, interventions and outcomes in the first nationwide audit. Gut 2018. link 69 Chung CS, Chen KC, Chou YH, Chen KH. Emergent single-balloon enteroscopy for overt bleeding of small intestinal vascular malformation. World journal of gastroenterology 2018. link 70 Heublein V, Pannach S, Daschkow K, Tittl L, Beyer-Westendorf J. Gastrointestinal endoscopy in patients receiving novel direct oral anticoagulants: results from the prospective Dresden NOAC registry. Journal of gastroenterology 2018. link 71 Shah AR, Jala V, Arshad H, Bilal M. Evaluation and management of lower gastrointestinal bleeding. Disease-a-month : DM 2018. link 72 López Rosés L, Álvarez B, González Ramírez A, López Baz A, Fernández López A, Alonso S et al.. Viability of single balloon enteroscopy performed under endoscopist-directed sedation. Revista espanola de enfermedades digestivas 2018. link 73 Park CH, Park SW, Hyun B, Lee J, Kae SH, Jang HJ et al.. Efficacy and safety of etomidate-based sedation compared with propofol-based sedation during ERCP in low-risk patients: a double-blind, randomized, noninferiority trial. Gastrointestinal endoscopy 2018. link 74 Gultekingil A, Teksam O, Gulsen HH, Ates BB, Saltık-Temizel İN, Demir H. Risk factors associated with clinically significant gastrointestinal bleeding in pediatric ED. The American journal of emergency medicine 2018. link 75 Brodie MM, Newman JC, Smith T, Rockey DC. Severity of Gastrointestinal Bleeding in Patients Treated with Direct-Acting Oral Anticoagulants. The American journal of medicine 2018. link 76 Nagata N, Yasunaga H, Matsui H, Fushimi K, Watanabe K, Akiyama J et al.. Therapeutic endoscopy-related GI bleeding and thromboembolic events in patients using warfarin or direct oral anticoagulants: results from a large nationwide database analysis. Gut 2018. link 77 Puri K, Caldwell RL, Molleston JP. Role of Octreotide in Pediatric Gastrointestinal Bleeding Secondary to Angiodysplasia in Children With Right Heart Failure. Journal of pediatric gastroenterology and nutrition 2018. link 78 Velayos Jiménez B, Alcaide Suárez N, González Redondo G, Fernández Salazar L, Aller de la Fuente R, Del Olmo Martínez L et al.. Impact of the endoscopist's experience on the negative predictive value of capsule endoscopy. Gastroenterologia y hepatologia 2017. link 79 Srisarajivakul N, Lucero C, Wang XJ, Poles M, Gillespie C, Zabar S et al.. Disruptive behavior in the workplace: Challenges for gastroenterology fellows. World journal of gastroenterology 2017. link 80 Fradkov E, Goldowsky A, Quiles K, Williams R. A Quality Improvement Educational Intervention to Increase Knowledge of Cardiogastroenterology Amongst Medical Trainees and Nursing Staff. MedEdPORTAL : the journal of teaching and learning resources 2017. link 81 Romano C, Oliva S, Martellossi S, Miele E, Arrigo S, Graziani MG et al.. Pediatric gastrointestinal bleeding: Perspectives from the Italian Society of Pediatric Gastroenterology. World journal of gastroenterology 2017. link 82 Balaban O, Kamata M, Hakim M, Tumin D, Tobias JD. The effect of esophagogastroduodenoscopy probe insertion on the intracuff pressure of airway devices in children during general anesthesia. Journal of anesthesia 2017. link 83 Shin S, Park CH, Kim HJ, Park SH, Lee SK, Yoo YC. Patient satisfaction after endoscopic submucosal dissection under propofol-based sedation: a small premedication makes all the difference. Surgical endoscopy 2017. link 84 McPherson SJ, Sinclair MT, Smith NCE. Severe Gastrointestinal Haemorrhage: Summary of a National Quality of Care Study with Focus on Radiological Services. Cardiovascular and interventional radiology 2017. link 85 Tomlin AM, Reith DM, Woods DJ, Lloyd HS, Smith A, Fountain JS et al.. A Pharmacoepidemiology Database System for Monitoring Risk Due to the Use of Medicines by New Zealand Primary Care Patients. Drug safety 2017. link 86 She WH, Tsang S, Poon R, Cheung TT. Gastrointestinal bleeding of obscured origin due to cystic artery pseudoaneurysm. Asian journal of surgery 2017. link 87 Chan LL, Lim CP, Lim CH, Tan TE, Sim D, Sivathasan C. Novel Use of Thalidomide in Recurrent Gastrointestinal Tract Bleeding in Patients with Left Ventricular Assist Devices: A Case Series. Heart, lung & circulation 2017. link 88 Seng BJJ, Teo LLY, Chan LL, Sim DKL, Kerk KL, Soon JL et al.. Novel use of low-dose thalidomide in refractory gastrointestinal bleeding in left ventricular assist device patients. The International journal of artificial organs 2017. link 89 Veitch AM, Vanbiervliet G, Gershlick AH, Boustiere C, Baglin TP, Smith LA et al.. Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines. Endoscopy 2016. link 90 Klare P, Reiter J, Meining A, Wagenpfeil S, Kronshage T, Geist C et al.. Capnographic monitoring of midazolam and propofol sedation during ERCP: a randomized controlled study (EndoBreath Study). Endoscopy 2016. link 91 Seo SI, Ryu JY, Kang SS, Lee JS, Kim HS, Jang MK et al.. Safety of Target-Controlled Propofol Infusion by Gastroenterologists in Patients Undergoing Endoscopic Resection. Digestive diseases and sciences 2016. link 92 Amornsawadwattana S, Nassif M, Raymer D, LaRue S, Chen CH. Video capsule endoscopy in left ventricular assist device recipients with obscure gastrointestinal bleeding. World journal of gastroenterology 2016. link 93 Yoo YC, Park CH, Shin S, Park Y, Lee SK, Min KT. A comparison of sedation protocols for gastric endoscopic submucosal dissection: moderate sedation with analgesic supplementation vs analgesia targeted light sedation. British journal of anaesthesia 2015. link 94 Kawano S, Okada H, Iwamuro M, Kouno Y, Miura K, Inokuchi T et al.. An effective and safe sedation technique combining target-controlled infusion pump with propofol, intravenous pentazocine, and bispectral index monitoring for peroral double-balloon endoscopy. Digestion 2015. link 95 Chandar R, Jagadisan B, Vasudevan A. Propofol-ketamine and propofol-fentanyl combinations for nonanesthetist-administered sedation. Journal of pediatric gastroenterology and nutrition 2015. link 96 Polacco MA, Ossoff J, Paydarfar J. Vallecular Varix: A Perplexing Cause of Oral Cavity Bleeding. The western journal of emergency medicine 2015. link 97 Garcia MC, Ahlenstiel G, Mahajan H, van der Poorten D. Small bowel varices secondary to chronic superior mesenteric vein thrombosis in a patient with heterozygous Factor V Leiden mutation: a case report. Journal of medical case reports 2015. link 98 Hsu WF, Tsang YM, Teng CJ, Chung CS. Protein C deficiency related obscure gastrointestinal bleeding treated by enteroscopy and anticoagulant therapy. World journal of gastroenterology 2015. link 99 McDonald CJ, Kalisch Ellett LM, Barratt JD, Caughey GE. An international comparison of spontaneous adverse event reports and potentially inappropriate medicine use associated with dabigatran. Pharmacoepidemiology and drug safety 2015. link 100 Sueta D, Hokimoto S, Tayama S, Tsujita K, Sakamoto K, Yamamoto E et al.. Clinical significance of fecal occult blood screening in patients before percutaneous coronary intervention. International journal of cardiology 2015. link

    Original source

    1. [1]
    2. [2]
      Propofol Sedation with a Target-Controlled Infusion Pump and Bispectral Index Monitoring System in Older Patients Undergoing Antegrade Balloon-Assisted Enteroscopy.Maeda N, Higashimori A, Okamura H, Fujimoto K, Kobayashi Y, Nakata A et al. Digestive diseases and sciences (2026)
    3. [3]
      Antithrombotics drugs in Gastrointestinal Endoscopy. Position Statment of the Catalan Society of Gastroenterology.Riu Pons F, Vilalta N, Ibáñez-Sanz G, Quintana-Carbó S, Calvo A, Uchima H et al. Gastroenterologia y hepatologia (2026)
    4. [4]
      Assessing the Impact of a Structured Capsule Endoscopy Training Program Using a New Validated Assessment Tool.Lima Capela T, Gonçalves JC, Ferreira AI, Macedo Silva V, Macedo C, Arieira C et al. Journal of gastroenterology and hepatology (2025)
    5. [5]
      Lower gastrointestinal bleeding from colonic varices of unknown origin.Jonnagaddala J, Ahmed S, Chayeb JME Clinics and research in hepatology and gastroenterology (2025)
    6. [6]
      Drug-Induced Spontaneous Intramural Hematoma of the Gastrointestinal Tract: A Real-World Pharmacovigilance Analysis.Wang X, Luo M, Li W, Zhou Y Journal of cardiovascular pharmacology (2025)
    7. [7]
      Severe Duodenal Bleeding with Heterotaxy Syndrome Controlled by Combined Hemostatic Strategies.Yomogida D, Kuwano H, Miyakoshi T, Mizuta S, Horikawa S, Koshida Y et al. Internal medicine (Tokyo, Japan) (2025)
    8. [8]
      Optimal direct oral anticoagulant for upper gastrointestinal endoscopic submucosal dissection.Ono Y, Hatta W, Tarasawa K, Ogata Y, Abe H, Sato I et al. Journal of gastroenterology (2025)
    9. [9]
    10. [10]
    11. [11]
      Pediatric advanced complex endoscopy team enhances endoscopy quality and provider satisfaction.Barakat MT, Bass D, Goyal A, Fink C, Mostamand S, Gugig R Journal of pediatric gastroenterology and nutrition (2024)
    12. [12]
      The Role of Imaging for Gastrointestinal Bleeding: Consensus Recommendations From the American College of Gastroenterology and Society of Abdominal Radiology.Sengupta N, Kastenberg DM, Bruining DH, Latorre M, Leighton JA, Brook OR et al. The American journal of gastroenterology (2024)
    13. [13]
      Emergency medicine updates: Lower gastrointestinal bleeding.Long B, Gottlieb M The American journal of emergency medicine (2024)
    14. [14]
      Variceal and Nonvariceal Upper Gastrointestinal Bleeding Refractory to Endoscopic Management: Indications and Role of Interventional Radiology.Meram E, Russell E, Ozkan O, Kleedehn M Gastrointestinal endoscopy clinics of North America (2024)
    15. [15]
      Management of Patients With Acute Lower Gastrointestinal Bleeding: An Updated ACG Guideline.Sengupta N, Feuerstein JD, Jairath V, Shergill AK, Strate LL, Wong RJ et al. The American journal of gastroenterology (2023)
    16. [16]
      Implementation of a Bleeding Risk Screening Tool and Hematology Referral Process Prior to Pediatric Endoscopy.McSorley B, Chugh A, Abazi T, Lerner D, Jobe S, Pan AY et al. Journal of pediatric gastroenterology and nutrition (2023)
    17. [17]
    18. [18]
      Management and clinical outcomes for patients with gastrointestinal bleeding who decline transfusion.Asiedu JO, Thomas AJ, Cruz NC, Nicholson R, Resar LMS, Khashab M et al. PloS one (2023)
    19. [19]
      A randomized, controlled clinical trial comparing remimazolam to propofol when combined with alfentanil for sedation during ERCP procedures.Dong SA, Guo Y, Liu SS, Wu LL, Wu LN, Song K et al. Journal of clinical anesthesia (2023)
    20. [20]
      Treatment of colonic varices and gastrointestinal bleeding by recanalization and stenting of splenic-vein-thrombosis: A case report and literature review.Füssel LM, Müller-Wille R, Dinkhauser P, Schauer W, Hofer H World journal of gastroenterology (2023)
    21. [21]
      Under-reporting of gastrointestinal bleeding associated with anticoagulant use using the UK Yellow Card Scheme.Shuttleworth P, Baker J, Clark E International journal of clinical pharmacy (2023)
    22. [22]
      Warfarin Is Associated With Higher Rates of Upper But Not Lower Gastrointestinal Bleeding Compared with Direct Oral Anticoagulants: A Population-Based Propensity-Weighted Cohort Study.Ingason AB, Hreinsson JP, Agustsson AS, Lund SH, Rumba E, Palsson DA et al. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association (2023)
    23. [23]
      Obscure Gastrointestinal Bleeding Caused by a Small Intestinal Lymphatic-venous Malformation: A Case Report with a Literature Review.Hamada Y, Umeda Y, Ikenoyama Y, Shigefuku A, Yukimoto H, Nakamura M et al. Internal medicine (Tokyo, Japan) (2023)
    24. [24]
    25. [25]
      Video Capsule Endoscopy and Device-Assisted Enteroscopy.Hanscom M, Stead C, Feldman H, Marya NB, Cave D Digestive diseases and sciences (2022)
    26. [26]
      A Rare Cause of Recurrent Melena: Haemangioma of the Small Intestine.Chi F, Lan Y, Jiang L Journal of the College of Physicians and Surgeons--Pakistan : JCPSP (2022)
    27. [27]
      The Evolution of Gastrointestinal Bleeding: A Holistic Investigation of Global Outputs with Bibliometric Analysis.Kudu E, Danış F The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology (2022)
    28. [28]
    29. [29]
      Acute gastrointestinal bleeding: A comparison between variceal and nonvariceal gastrointestinal bleeding.Raţiu I, Lupuşoru R, Popescu A, Sporea I, Goldiş A, Dănilă M et al. Medicine (2022)
    30. [30]
      Risk factors for emergency department revisit in elderly patients with gastrointestinal bleeding secondary to anticoagulant therapy.Ruiz J, López-Vinardell L, Juanes A, Riera-Magallon A, Puig M, Mangues MA European journal of hospital pharmacy : science and practice (2022)
    31. [31]
      Comorbidities Associated with Worse Outcomes Among Inpatients Admitted for Acute Gastrointestinal Bleeding.Siebenhüner K, Blaser J, Nowak A, Cheetham M, Mueller BU, Battegay E et al. Digestive diseases and sciences (2022)
    32. [32]
      Causes of gastrointestinal bleeding in oral anticoagulant users compared to non-users in a population-based study.Ágústsson AS, Ingason AB, Rumba E, Pálsson D, Reynisson IE, Hreinsson JP et al. Scandinavian journal of gastroenterology (2022)
    33. [33]
    34. [34]
      Diagnosis and management of acute lower gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.Triantafyllou K, Gkolfakis P, Gralnek IM, Oakland K, Manes G, Radaelli F et al. Endoscopy (2021)
    35. [35]
    36. [36]
      Transfusion-associated circulatory overload in gastroenterology.Piccin A, Spizzo G, Popovski MA, Russo FP, Armanaschi L, Vecchiato C et al. Blood transfusion = Trasfusione del sangue (2021)
    37. [37]
      Effect of COVID-19 pandemic on workflows and infection prevention strategies of endoscopy units in Hungary: a cross-sectional survey.Bor R, Szántó KJ, Fábián A, Farkas K, Szűcs M, Rutka M et al. BMC gastroenterology (2021)
    38. [38]
      Gastrointestinal bleeding in patients admitted to cardiology: risk factors and a new risk score.Zhang M, Liu D, Wang Q, Geng X, Hou Q, Gu G et al. Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese (2021)
    39. [39]
      Admission discipline and timing of admission may influence outcomes for gastrointestinal bleeding patients.Chue KM, Boey JY, Ng BSM, Teh JL, Kim G, Shabbir A et al. ANZ journal of surgery (2021)
    40. [40]
      Long-term treatment with thalidomide for severe recurrent hemorrhage from intestinal angiodysplasia in Glanzmann Thrombasthenia.Paciullo F, Fierro T, Calcinaro F, Zucca Giucca G, Gresele P, Bury L Platelets (2021)
    41. [41]
      Small Bowel Angioectasias Rebleeding and the Identification of Higher Risk Patients.Arieira C, Magalhães R, Dias de Castro F, Boal Carvalho P, Rosa B, Moreira MJ et al. Digestive diseases and sciences (2021)
    42. [42]
      Gastrointestinal Bleeding Rates in Left Ventricular Assist Device Population Reduced with Octreotide Utilization.Wilson TJ, Baran DA, Herre JM, Cameron CM, Yehya A, Ingemi AI ASAIO journal (American Society for Artificial Internal Organs : 1992) (2021)
    43. [43]
    44. [44]
      Rapid and Safe Crossing of the Chasm: Application of a Flipped Learning Framework for the Clipping Over the Scope Technique.Soetikno R, Asokkumar R, Chin YK, Salazar E, Nguyen-Vu T, Sanduleanu S et al. Gastrointestinal endoscopy clinics of North America (2020)
    45. [45]
      Faculty Development Workshop for Endoscopic Teaching Techniques.Pourmand K, Nagula S, Keefer L, Shah B MedEdPORTAL : the journal of teaching and learning resources (2020)
    46. [46]
      Drastic decrease of urgent endoscopies outside regular working hours during the Covid-19 pandemic in the paris area.Becq A, Jais B, Fron C, Rotkopf H, Perrod G, Rudler M et al. Clinics and research in hepatology and gastroenterology (2020)
    47. [47]
      Propofol sedation with a target-controlled infusion pump in elderly patients undergoing ERCP.Ogawa T, Tomoda T, Kato H, Akimoto Y, Tanaka S, Okada H Gastrointestinal endoscopy (2020)
    48. [48]
      Risks for Rebleeding and In-Hospital Mortality after Gastrointestinal Bleeding in a Tertiary Referral Center in Japan.Fukuda S, Shimodaira Y, Watanabe K, Takahashi S, Sugawara K, Suzuki Y et al. Digestion (2020)
    49. [49]
      Utility of fecal immunochemical test vs guaiac fecal occult blood test for assessment of gastrointestinal bleed in hospitalized patients.Sokoro A, Shafer LA, Darr M, Singh H Clinica chimica acta; international journal of clinical chemistry (2020)
    50. [50]
      Ethnic inequality in non-steroidal anti-inflammatory drug-associated harm in New Zealand: A national population-based cohort study.Tomlin A, Woods DJ, Lambie A, Eskildsen L, Ng J, Tilyard M Pharmacoepidemiology and drug safety (2020)
    51. [51]
      Endoscopic Algorithm for Management of Gastrointestinal Bleeding in Patients With Continuous Flow LVADs: A Prospective Validation Study.Axelrad JE, Faye AS, Pinsino A, Thanataveerat A, Cagliostro B, Pineda MFT et al. Journal of cardiac failure (2020)
    52. [52]
    53. [53]
      Gastrointestinal Endoscopy Editorial Board top 10 topics: advances in GI endoscopy in 2018.Cohen J, Desilets DJ, Hwang JH, Kyanam Kabir Baig KR, Leung FW, Maranki JL et al. Gastrointestinal endoscopy (2019)
    54. [54]
      Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology.Oakland K, Chadwick G, East JE, Guy R, Humphries A, Jairath V et al. Gut (2019)
    55. [55]
      Acute lower gastrointestinal bleeding: are STRATE and BLEED scores valid in clinical practice?Xavier SA, Machado FJ, Magalhães JT, Cotter JB Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland (2019)
    56. [56]
      Jejunal varices: an unconsidered cause of recurrent gastrointestinal haemorrhage.Heiberger CJ, Mehta TI, Yim D BMJ case reports (2019)
    57. [57]
      Endovascular Therapy of Gastrointestinal Bleeding.Augustin AM, Fluck F, Bley T, Kickuth R RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin (2019)
    58. [58]
      Characteristics of patients treated for active lower gastrointestinal bleeding detected by CT angiography: Interventional radiology versus surgery.Pannatier M, Duran R, Denys A, Meuli R, Zingg T, Schmidt S European journal of radiology (2019)
    59. [59]
    60. [60]
      Chronic GI bleeding in a middle-aged woman.Kitamoto H, Fukushima M, Inokuma T Gut (2019)
    61. [61]
      Periendoscopic management of direct oral anticoagulants: a prospective cohort study.Radaelli F, Fuccio L, Paggi S, Hassan C, Repici A, Rondonotti E et al. Gut (2019)
    62. [62]
      Procedural sedation by advanced care paramedics for emergency gastrointestinal endoscopy.Wiemer HM, Butler MB, Froese PC, Lapierre A, Carriere C, Etsell GR et al. CJEM (2019)
    63. [63]
      Experience of the use of octreotide for refractory gastrointestinal bleeding in a patient with Jarvik2000Nakajima-Doi S, Seguchi O, Shintani Y, Fujita T, Fukushima S, Matsumoto Y et al. Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs (2019)
    64. [64]
    65. [65]
      G6b-B: the "Y's" and wherefores.Newman DK Blood (2018)
    66. [66]
    67. [67]
      Rodenticide Causing Lower Gastrointestinal Bleeding: Resident Simulation.Sangal RB, Conlon LW MedEdPORTAL : the journal of teaching and learning resources (2018)
    68. [68]
      Acute lower GI bleeding in the UK: patient characteristics, interventions and outcomes in the first nationwide audit.Oakland K, Guy R, Uberoi R, Hogg R, Mortensen N, Murphy MF et al. Gut (2018)
    69. [69]
      Emergent single-balloon enteroscopy for overt bleeding of small intestinal vascular malformation.Chung CS, Chen KC, Chou YH, Chen KH World journal of gastroenterology (2018)
    70. [70]
      Gastrointestinal endoscopy in patients receiving novel direct oral anticoagulants: results from the prospective Dresden NOAC registry.Heublein V, Pannach S, Daschkow K, Tittl L, Beyer-Westendorf J Journal of gastroenterology (2018)
    71. [71]
      Evaluation and management of lower gastrointestinal bleeding.Shah AR, Jala V, Arshad H, Bilal M Disease-a-month : DM (2018)
    72. [72]
      Viability of single balloon enteroscopy performed under endoscopist-directed sedation.López Rosés L, Álvarez B, González Ramírez A, López Baz A, Fernández López A, Alonso S et al. Revista espanola de enfermedades digestivas (2018)
    73. [73]
    74. [74]
      Risk factors associated with clinically significant gastrointestinal bleeding in pediatric ED.Gultekingil A, Teksam O, Gulsen HH, Ates BB, Saltık-Temizel İN, Demir H The American journal of emergency medicine (2018)
    75. [75]
      Severity of Gastrointestinal Bleeding in Patients Treated with Direct-Acting Oral Anticoagulants.Brodie MM, Newman JC, Smith T, Rockey DC The American journal of medicine (2018)
    76. [76]
    77. [77]
      Role of Octreotide in Pediatric Gastrointestinal Bleeding Secondary to Angiodysplasia in Children With Right Heart Failure.Puri K, Caldwell RL, Molleston JP Journal of pediatric gastroenterology and nutrition (2018)
    78. [78]
      Impact of the endoscopist's experience on the negative predictive value of capsule endoscopy.Velayos Jiménez B, Alcaide Suárez N, González Redondo G, Fernández Salazar L, Aller de la Fuente R, Del Olmo Martínez L et al. Gastroenterologia y hepatologia (2017)
    79. [79]
      Disruptive behavior in the workplace: Challenges for gastroenterology fellows.Srisarajivakul N, Lucero C, Wang XJ, Poles M, Gillespie C, Zabar S et al. World journal of gastroenterology (2017)
    80. [80]
      A Quality Improvement Educational Intervention to Increase Knowledge of Cardiogastroenterology Amongst Medical Trainees and Nursing Staff.Fradkov E, Goldowsky A, Quiles K, Williams R MedEdPORTAL : the journal of teaching and learning resources (2017)
    81. [81]
      Pediatric gastrointestinal bleeding: Perspectives from the Italian Society of Pediatric Gastroenterology.Romano C, Oliva S, Martellossi S, Miele E, Arrigo S, Graziani MG et al. World journal of gastroenterology (2017)
    82. [82]
    83. [83]
    84. [84]
      Severe Gastrointestinal Haemorrhage: Summary of a National Quality of Care Study with Focus on Radiological Services.McPherson SJ, Sinclair MT, Smith NCE Cardiovascular and interventional radiology (2017)
    85. [85]
      A Pharmacoepidemiology Database System for Monitoring Risk Due to the Use of Medicines by New Zealand Primary Care Patients.Tomlin AM, Reith DM, Woods DJ, Lloyd HS, Smith A, Fountain JS et al. Drug safety (2017)
    86. [86]
      Gastrointestinal bleeding of obscured origin due to cystic artery pseudoaneurysm.She WH, Tsang S, Poon R, Cheung TT Asian journal of surgery (2017)
    87. [87]
      Novel Use of Thalidomide in Recurrent Gastrointestinal Tract Bleeding in Patients with Left Ventricular Assist Devices: A Case Series.Chan LL, Lim CP, Lim CH, Tan TE, Sim D, Sivathasan C Heart, lung & circulation (2017)
    88. [88]
      Novel use of low-dose thalidomide in refractory gastrointestinal bleeding in left ventricular assist device patients.Seng BJJ, Teo LLY, Chan LL, Sim DKL, Kerk KL, Soon JL et al. The International journal of artificial organs (2017)
    89. [89]
    90. [90]
      Capnographic monitoring of midazolam and propofol sedation during ERCP: a randomized controlled study (EndoBreath Study).Klare P, Reiter J, Meining A, Wagenpfeil S, Kronshage T, Geist C et al. Endoscopy (2016)
    91. [91]
      Safety of Target-Controlled Propofol Infusion by Gastroenterologists in Patients Undergoing Endoscopic Resection.Seo SI, Ryu JY, Kang SS, Lee JS, Kim HS, Jang MK et al. Digestive diseases and sciences (2016)
    92. [92]
      Video capsule endoscopy in left ventricular assist device recipients with obscure gastrointestinal bleeding.Amornsawadwattana S, Nassif M, Raymer D, LaRue S, Chen CH World journal of gastroenterology (2016)
    93. [93]
    94. [94]
    95. [95]
      Propofol-ketamine and propofol-fentanyl combinations for nonanesthetist-administered sedation.Chandar R, Jagadisan B, Vasudevan A Journal of pediatric gastroenterology and nutrition (2015)
    96. [96]
      Vallecular Varix: A Perplexing Cause of Oral Cavity Bleeding.Polacco MA, Ossoff J, Paydarfar J The western journal of emergency medicine (2015)
    97. [97]
    98. [98]
      Protein C deficiency related obscure gastrointestinal bleeding treated by enteroscopy and anticoagulant therapy.Hsu WF, Tsang YM, Teng CJ, Chung CS World journal of gastroenterology (2015)
    99. [99]
      An international comparison of spontaneous adverse event reports and potentially inappropriate medicine use associated with dabigatran.McDonald CJ, Kalisch Ellett LM, Barratt JD, Caughey GE Pharmacoepidemiology and drug safety (2015)
    100. [100]
      Clinical significance of fecal occult blood screening in patients before percutaneous coronary intervention.Sueta D, Hokimoto S, Tayama S, Tsujita K, Sakamoto K, Yamamoto E et al. International journal of cardiology (2015)

    HemoChat

    by SPINAI

    Evidence-based clinical decision support powered by SNOMED-CT, Neo4j GraphRAG, and NASS/AO/NICE guidelines.

    ⚕ For clinical reference only. Not a substitute for professional judgment.

    © 2026 HemoChat. All rights reserved.
    Research·Pricing·Privacy & Terms·Refund·SNOMED-CT · NASS · AO Spine · NICE · GraphRAG