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Feeding the patients with upper gastrointestinal bleeding.
MedLine Citation:
PMID:  21252654     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: It is usually believed that in case of upper gastrointestinal bleeding patients must be systematically fasted. This review will focus on oral and/or enteral feeding in patients with or at risk of upper gastrointestinal bleeding. RECENT FINDINGS: In case of upper gastrointestinal bleeding, an endoscopy is always required in order to determine the pathophysiology of the bleeding, and in some case to perform an endoscopic treatment. In patients hospitalized in ICU, enteral nutrition is the best stress ulcer prophylaxis. In patients with enteral nutrition the concomitant use of histamine-2 receptor blockers or proton-pump inhibitors may be harmful. In case of bleeding due to gastric erosions, enteral nutrition can be resumed as soon as the patient tolerates. In patients with liver cirrhosis nonbleeding oesophageal varices are not a contraindication for enteral nutrition nor nasogastric tube. In patients hospitalized for acute upper gastrointestinal bleeding due to an ulcer with high risk of rebleeding (Forrest I-IIb) or with variceal bleeding it is recommended to wait at least 48 h after endoscopic therapy before initiating oral or enteral feeding. In case of ulcer with low risk of rebleeding (Forrest IIc and III) or in patients with gastritis, Mallory-Weiss, oesophagitis, or angiodysplasia, there is no need to delay refeeding, and they can be fed as soon as tolerated. SUMMARY: Understanding the cause of the diagnosis is always necessary to adapt nutrition in patients with upper gastrointestinal bleeding.
Authors:
Xavier Hébuterne; Geoffroy Vanbiervliet
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-19
Journal Detail:
Title:  Current opinion in clinical nutrition and metabolic care     Volume:  -     ISSN:  1535-3885     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9804399     Medline TA:  Curr Opin Clin Nutr Metab Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Gastroenterology and Clinical Nutrition, CHU of Nice, University of Nice Sophia-Antipolis, Nice, France.
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