Repeat endoscopy may be considered on a case-by-case basis if there are clinical signs of recurrent bleeding or if there is uncertainty regarding the effectiveness of hemostasis during the initial treatment. However, planned second-look endoscopy that is performed within 24 hours after initial endoscopic therapy is generally not recommended. Even though such a procedure was shown to be efficacious in two meta-analyses, it provided only a limited reduction in the rate of rebleeding. Also, the procedure may not be cost-effective when medical therapy leading to profound acid suppression is initiated.
What test should be included in the long-term management and treatment of patients after acute peptic ulcer bleeding?
Ans: Testing for and treatment of H. pylori infection are critical considerations in the long-term management and treatment of patients after acute peptic ulcer bleeding.
What is the precise definition of postural changes or orthostatic hypotension?
Ans: Postural changes or orthostatic hypotension is defined as an increase in the pulse of ≥20 or more beats per minute or a drop in systolic blood pressure of over 20 mm Hg on standing after the patient has been in a recumbent position for at least five minutes.
New England Journal of Medicine - Vol. 359, No. 9, August 28, 2008