Acute gastrointestinal bleeding in the intensive care unit - The gastroenterologist's perspective

Gastrointestinal bleeding in the intensive care unit (ICU) may result from stress related erosive syndrome (SRES) and nonocclusive mesenteric vasculop athy (NOMV). A relative reduction in mesenteric perfusion that occurs in th e critically ill patient contributes to the pathogenesis of both diseases. Advances in ICU management have resulted in a decrease in the incidence of SRES and NOMV. In addition, prophylactic pharmacologic therapy with antacid s or acid suppressive therapy has contributed in part to the considerable r eduction in the incidence; of SRES. Nevertheless, for SRES and NOMV, treatm ent of the underlying disease remains the most important factor in preventi on.