Calc Function

  • Diagnosis
  • Rule Out
  • Prognosis
  • Formula
  • Treatment
  • Algorithm
  • Disease
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    Specialty
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    Chief Complaint
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    Organ System
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    Upper Gastrointestinal and Ulcer Bleeding

    Official guideline from the American College of Gastroenterology, updated May 2021.

    Risk Stratification

    Risk Stratification

    Conditional recommendation
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    Very low quality evidence

    Red Blood Cell Transfusion

    Red Blood Cell Transfusion

    Conditional recommendation
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    Low quality evidence

    Pre-endoscopic Medical Therapy

    Prokinetic Therapy with Erythromycin

    Conditional recommendation
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    Very low quality evidence

    Proton Pump Inhibitor (PPI) Therapy

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    Endoscopy for UGIB

    Timing of Endoscopy

    Conditional recommendation
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    Very low quality evidence

    Endoscopic Hemostatic Therapy

    Strong recommendation
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    Moderate quality evidence

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    Choice of Endoscopic Hemostatic Therapy for Bleeding Ulcers

    Strong recommendation
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    Moderate quality evidence

    Conditional recommendation
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    Strong recommendation
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    Conditional recommendation
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    Very low quality evidence

    Conditional recommendation
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    Low quality evidence

    Hemostatic Therapy for Bleeding Ulcers

    Antisecretory Therapy After Endoscopic Hemostatic Therapy for Bleeding Ulcers

    Strong recommendation
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    Conditional recommendation
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    Low quality evidence

    Recurrent Ulcer Bleeding After Successful Endoscopic Hemostatic Therapy

    Conditional recommendation
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    Failure of Endoscopic Hemostatic Therapy for Bleeding Ulcers

    Conditional recommendation
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    Very low quality evidence

    How strong is the ACG's recommendation?

    Strong recommendation
    Intervention's desirable effects clearly outweigh undesirable effects.
    Conditional recommendation
    Uncertainty in tradeoffs between desirable & undesirable effects of intervention.
    Strength of recommendation is not applicable.
    Between high and moderate levels of evidence.
    Moderate quality evidence
    Further research likely to impact confidence in estimate of effect.
    Between moderate and very low levels of evidence.
    Low quality evidence
    Further research expected to have important impact in confidence in estimate of effect.
    Between low and very low levels of evidence.
    Very low quality evidence
    Effect is very uncertain.
    Level of evidence is not applicable.