AI Article Synopsis

  • The study aimed to compare how university-affiliated (UA) and non-university-affiliated (non-UA) gastroenterologists manage acute peptic ulcer bleeding (APUB) based on a survey sent out in Canada.
  • Both groups showed no significant differences in practices related to acid suppression and endoscopic therapy, though individual variability existed within each group.
  • Non-UA gastroenterologists were noted to be more cautious, taking longer to restart medications like acetylsalicylic acid and warfarin after APUB, highlighting the need for further research on optimal treatment practices.

Article Abstract

Background: Practices relating to acute peptic ulcer bleeding (APUB) outside of guideline recommendations are unknown.

Objective: To evaluate the practices of university-affiliated (UA) versus nonuniversity-affiliated (non-UA) gastroenterologists in controversial APUB issues.

Methods: Gastroenterologists in Canada were mailed an anonymous questionnaire (January 2008) regarding APUB management.

Results: Responses were received for 281 of the 530 questionnaires mailed (53%). There were no differences between the UA versus non-UA gastroenterologists regarding acid suppression medication and route of administration pre- and postendoscopy (all P>0.05). There were no differences in endoscopic practices between groups regarding large versus small volume injection, endoclip versus combination injection plus coagulation, endoclip versus endoclip plus injection, and management of adherent clots (all P>0.05). There was variability within each group regarding optimal empirical acid suppression pre- and postendoscopy, volume of injection therapy and endoclip use. The non-UA group had longer delays before restarting acetylsalicyclic acid (P=0.08) and warfarin (P=0.02) post-APUB.

Conclusions: UA and non-UA gastroenterologists have similar practices in acid suppression and endoscopic therapy for controversial APUB issues; however, non-UA gastroenterologists appear more cautious in restarting acetylsalicylic acid and warfarin. Further studies are needed to address the optimal empirical acid suppression pre- and postendoscopy, injection therapy volume, endoclip use, and timing of restarting antiplatelet and anticoagulation therapy.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2864623PMC
http://dx.doi.org/10.1155/2010/709573DOI Listing

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