Endoscopic management of gastrointestinal hemorrhage

Endoscopy has clearly been broadened in the 1980s from simply a diagnostic tool to a procedure with therapeutic potential. Therapeutic endoscopy is a rapidly advancing field within gastroenterology. The widespread availability of endoscopes and skilled endoscopists allows the application of hemostatic techniques to control GI bleeding at the time of diagnostic endoscopy. Acute sclerotherapy can control active variceal hemorrhage, and repeated long-term sclerotherapy reduces the rate of rebleeding and improves survival of cirrhotic patients. A substantial body of literature confirms that laser treatment of a number of bleeding GI lesions is efficacious. Preliminary studies of BICAP and heater probe thermal techniques and of injection therapy for nonvariceal bleeding suggests that all of these modalities are efficacious. Future controlled studies are necessery to define which of these various techniques will become the ideal technology that is effective in securing hemostasis, simple and easy to use, readily available, reasonable in cost, and safe.