The Role of Hemostatic Powder in Endoscopic Hemostasis of Nonvariceal Upper Gastrointestinal Bleeding

Haematemesis and malena are the two most important symptoms of upper gastrointestinal bleeding . The most common cause of upper gastrointestinal bleeding is due to a peptic ulcer. In this paper, the authors research the cause of bleeding. Contrary to previous studies, results favor esophageal varices, e.g., alcoholism or cirrhosis liver post necrotic, as the most common cause of bleeding rather than a peptic ulcer. The authors’ study is based on an observational retrospective protocol with records of 50 consecutive patients with GI bleeding, attending the emergency room from February 2007 until September 2009. Results show that the treatment of UGI bleeding has made important progress since the introduction of emergency endoscopy and endoscopic techniques for haemostasis. The application of specific protocols significantly decreases rebleeding and the need for surgery, whereas mortality is still high. The data highlight the decreasing trend of peptic ulcer as the sole cause of bleeding, as shown in previous literature, ascertaining that varices are now the most common variable.

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Use of hemostatic powder in treatment of upper gastrointestinal bleeding: a systematic review and meta-analysis

Endoscopy International Open ◽

10.1055/a-0977-2897 ◽

2019 ◽

Vol 07 (12) ◽

pp. E1704-E1713 ◽

Cited By ~ 4

Author(s):

Daniel Tavares de Rezende ◽

Vitor Ottoboni Brunaldi ◽

Wanderley Marques Bernardo ◽

Igor Braga Ribeiro ◽

Raquel Cristina Lins Mota ◽

...

Keyword(s):

Systematic Review ◽

Gastrointestinal Bleeding ◽

Latin American ◽

Upper Gastrointestinal Bleeding ◽

Rescue Therapy ◽

Meta Analysis ◽

Secondary Outcome ◽

Primary Hemostasis ◽

Hemostatic Powder ◽

Upper Gastrointestinal

Abstract Background and study aims TC-325 is a novel mineral hemostatic powder that creates a mechanical barrier by absorbing blood components and promoting clotting. Recently approved for use in humans, it has shown promise for treatment of upper gastrointestinal bleeding (UGIB). However, because there have been no large studies of TC-325, its true efficacy and safety profile remain unknown. We performed a systematic review and meta-analysis to determine the safety and efficacy of TC-325 in treating UGIB, based on rates of initial hemostasis, rebleeding, and adverse events (AEs). Methods We searched the MEDLINE/PubMed, EMBASE, CENTRAL, Latin-American and Caribbean Health Sciences Literature databases, as well as the gray literature, to identify articles describing use of TC-325 up to October 2018. Primary outcomes were initial hemostasis and rebleeding. AEs were described as a secondary outcome. Risk of bias was assessed with international scores. Results We identified 2077 records after removal of duplicates. We included 50 studies, involving a collective total of 1445 patients, in the quantitative synthesis. Primary hemostasis and rebleeding rates were 90.7 % and 26.1 %, respectively. Subgroup analyses showed similar results. Only eight AEs were reported. Conclusions TC-325 appears to be a safe, effective treatment for UGIB. The overall rate of initial hemostasis after TC-325 use is high, regardless of etiology of bleeding or whether TC-325 is used as a primary or rescue therapy. Although it is also associated with high rebleeding rates, rates of AEs and equipment failure after TC-325 use are extremely low.

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Role of Helicobacter pylori in Upper Gastrointestinal Bleeding Among Ischemic Stroke Hospitalizations: A Nationwide Study of Outcomes

Gastrointestinal Disorders ◽

10.3390/gidisord1030029 ◽

2019 ◽

Vol 1 (3) ◽

pp. 358-371

Author(s):

Urvish K. Patel ◽

Mihir Dave ◽

Anusha Lekshminarayanan ◽

Nidhi Patel ◽

Abhishek Lunagariya ◽

...

Keyword(s):

Helicobacter Pylori ◽

Ischemic Stroke ◽

Risk Stratification ◽

Gastrointestinal Bleeding ◽

Health Care Cost ◽

Upper Gastrointestinal Bleeding ◽

Increased Risk ◽

H Pylori ◽

Upper Gastrointestinal

Introduction: Helicobacter pylori (H. pylori) is a well-recognized risk factor for upper gastrointestinal bleeding (UGIB). The exposure to tissue plasminogen activator (tPA), anti-platelets, and anticoagulants increases the risk of UGIB in acute ischemic stroke (AIS) patients, the risk stratification of H. pylori infection is not known. In this retrospective cross-sectional study, we aimed to evaluate the relationship between H. pylori and GIB in patients hospitalized with AIS. Methods: In the nationwide data, hospitalization for AIS was identified by primary diagnosis using International Classification of Diseases, clinical modification (ICD-9-CM) codes. Subgroup of patients with GIB and H. pylori were identified in AIS cohort. A stepwise multivariable logistic regression model was fitted to evaluate the outcome of upper GIB and role of H. Pylori in UGIB. Results: Overall 4,224,924 AIS hospitalizations were identified, out of which 18,629 (0.44%) had UGIB and 3122 (0.07%) had H. pylori. The prevalence of H. pylori-induced UGIB among UGIB in AIS was 3.05%. The prevalence of UGIB was markedly elevated among the H. pylori infection group (18.23% vs. 0.43%; p < 0.0001) compared to the non-H. pylori group. In multivariable regression analysis, H. pylori was associated with markedly elevated odds of UGIB (aOR:27.75; 95%CI: 21.07–36.55; p < 0.0001). Conclusion: H. pylori infection had increased risk-adjusted occurrence of UGIB amongst the AIS hospitalized patients. H. pylori testing may improve risk stratification for UGIB and lower the health care cost burden in stroke hospitalization.

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