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Upper gastrointestinal (GI) bleeding is a common reason for hospital admission in older adult patients and carries a high morbidity and mortality if not properly managed. Risk factors include advanced age, Helicobacter pylori infection, medication use, smoking, and history of liver disease. Patients with known or suspected liver disease and suspected variceal bleeding should also receive antibiotics and somatostatin analogues. Risk stratification scores should be used to determine patients at highest risk for further decompensation. Upper endoscopy is both a diagnostic and therapeutic tool used in the management of upper GI bleeding. Endoscopy should be performed within 24 hours of presentation after appropriate resuscitation. Management of anticoagulation in upper GI bleeding largely depends on the indication for anticoagulation, the risk of continued bleeding with continuing the medication, and the risk of thrombosis with discontinuing the medication. A multidisciplinary approach to the decision of anticoagulation continuation is preferred when possible., (Copyright © 2020 Elsevier Inc. All rights reserved.)

This article summarizes current knowledge regarding the incidence of and risk factors associated with recurrent lower gastrointestinal hemorrhage. The literature regarding medical, endoscopic, and surgical methods to prevent rebleeding from diverticulosis, angioectasia, and chronic hemorrhagic radiation proctopathy is reviewed. In addition, the evidence for endoscopic clipping as primary prophylaxis against postpolypectomy bleeding is explored., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Minimizing endoscopic complications includes attention to the details about each patient's current medical condition before they undergo an invasive procedure. This article focuses on critical issues about proper preparation for endoscopic procedures and examines potential modifications to a patient's medical regimen near the time of an endoscopic procedure, highlighting recently published standards and guidelines. This article also reviews important issues related to infection control in endoscopy.

Gastrointestinal (GI) bleeding is an uncommon manifestation of AIDS despite the frequent involvement of the GI tract by infections, malignancies, and a variety of other disorders. GI bleeding may occur from a variety of causes, some specifically associated with AIDS and others unrelated to immunocompromise; most patients with AIDS who have lower GI bleeding have causes attributable to AIDS-specific lesions. Just as in an incompetent patient, an aggressive approach to diagnosis and treatment of GI bleeding in AIDS patients is warranted.