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Emergency General Surgery involves the urgent care of admitted surgical emergencies and accounts for over 10% of all hospital admissions and most have GI complaints. Gastroenterologists are fundamental to the management of patients with inflammatory bowel disease, ulcerative disease; both benign and malignant that bleeds and perforates. Gastroenterology should be involved in joint decision making, particularly in upper and lower GI bleeding and severe inflammatory bowel disease.

Low-dose aspirin (LDA) is now broadly administered for the prevention of cardiovascular and cerebrovascular diseases. However, aspirin, even at a low dose, induces adverse effects on both the upper and lower gastrointestinal tracts, which precludes patient adherence to the continuous administration of aspirin. A preventive strategy for LDA-induced upper GI tract injury is being established, and the risk factors include histories of peptic ulcer diseases and concomitant intake of nonsteroidal anti-inflammatory drugs, antiplatelet agents, anticoagulants, and oral steroids. Patients with these risk factors should be coadministered gastroprotective drugs, such as proton pump inhibitors, to prevent upper GI adverse events. By contrast, a preventive strategy for LDA-induced lower GI tract injury remains to be established, although new endoscopic techniques, such as capsule endoscopy and double balloon endoscopy, yield images of small intestinal injury induced by LDA. Because lower GI bleeding has increased in LDA users, whereas upper bleeding has decreased, a preventive strategy for LDA-induced lower GI tract injury must be urgently established.