Acute GI Bleeding: Detect Causes & Management Best Practices – Peter Buch

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The evaluation and treatment of GI bleeding is constantly evolving. There are a host of new therapeutic modalities. But equally important are the best times to apply these modalities. Please join Dr. Peter Buch for a practical, case based presentation which will provide you with the latest approach to treat GI bleeding.

Speaker

Peter Buch, MD, AGAF, FACP, is a double board-certified clinical gastroenterologist,  leading a team that treats all GI conditions. Dr. Buch sits on editorial boards for numerous professional journals and is a highly sought-after international presenter.

Dr. Buch has a passion for teaching. His style is case-based, practical, very interactive and evidence supported. Dr. Buch’s expertise has been shared with experienced clinicians and advanced-level students. He teaches at the University of Connecticut School of Medicine, the University of New England College of Osteopathic Medicine, the Frank H Netter School of Medicine/Quinnipiac University and the University of Connecticut APRN School.

Speaker Disclosures:

Financial: Dr. Peter S. Buch has employment relationships with the University of Connecticut School of Medicine, the University of New England College of Osteopathic Medicine, and the Frank H Netter, MD School of Medicine. He receives a speaking honorarium and recording royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Peter S. Buch serves on the FDA and Patient Care Committees at the American College of Gastroenterology. He serves as an editor of peer-reviewed journals. He is a member of the International Association of Medical Science Educators, the AGA Academy of Educators, the American Gastroenterological Association (AGAF), the American College of Physicians (FACP), the Hartford County Medical Association, the American College of Gastroenterology (FACG), and the Connecticut State Medical Society.

Content Disclosure:

Dr. Buch references the use of antidepressants for Irritable Bowel Syndrome, and the controversial use of Fibrotest to evaluate patients with fatty liver disease who may have fibrosis of the liver. Dr. Buch indicates he wishes to present a fair and balanced approach to practitioners regarding such practices.

Outline

Esophageal Ulcer Risk Factors

• Mallory Weiss tear vs Boerhaave’s syndrome

Risk factors for Peptic Ulcer Disease and PPI Prophylaxis

When to consider NG tubes

• Alternatives: Erythromycin IV

Endoscopic evaluation of UGI bleeding

• Timing of the procedure
• • Safety of INR and platelet count

• Which patients can be safely discharged home from the ER
• Visible vessels and interventions

Esophageal Varices

• Best treatment practices

Proton Pump Inhibitor

• Side effects

Hemoccult

• False positives and negatives

Fecal Immunochemical Testing (FIT)

• What is measured
• False positives and negatives
• • When NOT to use

Multitarget Stool DNA Test (Cologuard)

• What is measured
• False positives and negatives
• • When NOT to use

Evaluation of Small Bowel

• Enteroscope
• Capsule study
• MRI of small intestine

Colonoscopy

• Best timing
  • Capsule study
  • MRI or CT scan limitations

What is Interval Colorectal Cancer?

• How to avoid it

Colon Cancer

• Older patient and younger patient risk

Ulcerative Colitis

• Sources of exacerbations

Diverticular Bleeding

• What percentage stop spontaneously?
• Treatment for those who do not subside

Resuming Meds After a BI Bleed

• How to weigh pros and cons of timing
• ASA
• Anticoagulants

Objectives

1. Identify the risk factors that lead to UGI bleeding.
2. Recognize the best timing for interventions in UGI and LGI bleeding.
3. Describe the “best” testing for massive GI bleeding.
4. Recognize the safe use of anti-platelet and anticoagulation meds post GI bleed.

Target Audience

• Nurses
• Nurse Practitioners
• Clinical Nurse Specialists
• Physician Assistants

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