Gastrointestinal bleeding articles from across Nature Portfolio

Restrictive transfusion strategy saves blood and is safe in most clinical settings, including gastrointestinal bleeding. However, generalizability of a restrictive transfusion approach in acute gastrointestinal bleeding remains controversial as it often affects elderly patients with major cardiovascular comorbidity who have been excluded from existing trials.

A report has demonstrated that in patients with atrial fibrillation the novel oral anticoagulant, dabigatran, increases the risk of gastrointestinal bleeding by nearly twofold compared with warfarin. Here, the risk of gastrointestinal bleeding associated with anticoagulants and antiplatelet agents is placed into clinical context and key management principles are emphasized.

A new study suggests that co-prescription of low-dose aspirin and PPIs increases the incidence of small-bowel mucosal breaks. Should we be concerned about the potential negative interactions of these drugs? Or is the balance of evidence still substantially tipped towards the need for PPIs to protect against aspirin-induced upper gastrointestinal damage?