Management of patients with gastrointestinal bleeding

Acute gastrointestinal bleeding is a common cause of hospitalization and remains an important cause of death, despite improvements in medical and endoscopic treatments. An experienced team is essential for the management of gastrointestinal bleeding, as patients require intensive support before they undergo endoscopy, accurate endoscopic diagnosis and treatment of the bleeding site, and adequate management during follow-up. In recent decades, endoscopy has been playing a pivotal role in the diagnosis, therapy and categorization of the risk of digestive bleeding. The accessories used during an emergency endoscopy have been enriched over the years with new devices with different characteristics, functions and effectiveness, according to the lesions to be treated. Once haemostasis has been achieved, post-endoscopic management is essential to reduce the risk of rebleeding, evaluating early interventions, long-term ones and discharge criteria. The purpose of this review is to examine the current guidelines and recommendations, report recent evidence and provide expert opinions on the management of patients with gastrointestinal bleeding.