GI Bleeding

Upper and lower GI bleeding remain emergencies with evolving management protocols. The session covers AI risk-stratification (Glasgow-Blatchford, Rockall, AIMS65), hemostatic powders (Hemospray, EndoClot, PuraStat) for difficult bleeds, variceal hemorrhage management including TIPS, anticoagulation reversal in GI bleeding (idarucizumab, andexanet alfa), small-bowel bleeding workup with capsule endoscopy and balloon enteroscopy, and emerging mechanical hemostasis devices. Discussion addresses the timing of endoscopy in upper GI bleed, restrictive vs liberal transfusion strategy, the role of PPI infusion, lower GI bleed evaluation pathway, and the cost-effectiveness of various hemostatic techniques in low-resource settings.