Pharmacologic treatment of upper gastrointestinal bleeding

The first goal of therapy is to assess hemodynamic stability in a patient presenting with evidence of upper gastrointestinal bleeding and, second, to maintain hemodynamic stability using crystalloids or packed red blood cells. The diagnosis of the cause of upper gastrointestinal bleeding should be performed using endoscopic techniques, which should be performed early. Therapy directed at treating the cause of upper gastrointestinal bleeding should be initiated at the time of endoscopy. Pharmacologic management should be based on the prevention of ulcer rebleeding and should be initiated at the time of endoscopic diagnosis. Surgery should be considered only in cases when endoscopic and pharmacologic treatments are deemed a failure.