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Guidelines for Non-Variceal Upper Gastrointestinal Haemorrhage

Guidelines for acute gastrointestinal bleeding

The BSG guidelines for acute variceal and non-variceal haemorrhage were written 8 and 6 years ago and have become dated. Acute upper gastrointestinal bleeding is a major emergency and the recent National, UK-wide audit demonstrated significant deficiencies in service provision and care, and it is therefore appropriate to update the evidence base for managing acutely bleeding patients. The Scottish Inter-collegiate Guideline Network (SIGN) have, this year, published their guideline ‘Management of Acute Upper and Lower GI Bleeding’. This well researched document covers modern management of varices, non-variceal upper gastrointestinal and acute colonic bleeding. Rather than council commissioning further working parties and guideline groups to revise the BSG bleeding guidelines we have decided to commend the SIGN document and adopt it as standard of care for these conditions. The SIGN guideline can be found here


March 2011: New guidance to stop people dying from acute gastric bleeding

CROMES Project: 'Scope for Improvement: A toolkit for a safer Upper Gastrointestinal Bleeding (UGIB) service'

A BSG led UK-wide audit in 2007 highlighted significant deficiencies and inconsistencies in service provision and care of patients presenting with UGIB. The BSG, under Kel Palmer's stewardship, undertook a piece of research, initiated under the title of Consultant Rota On-call Modelling of Endoscopy Services (CROMES).

The BSG has worked with the Royal College of Physicians, Royal College of Radiologists, National Patient Safety Agency and Royal College of Nursing to develop a toolkit to provide practical support to providers and commissioners to consider changes to their UGIB services to help improve the quality of care and outcomes for patients with UGIB. The Toolkit may be downloaded below from the AOMRC website: