Endoscopy within six hours did not improve outcomes in non-variceal upper GI bleeding

The edition in brief

A meta-analysis of nine studies with 10,785 adults with non-variceal upper gastrointestinal bleeding found endoscopy within six hours did not reduce mortality (OR 0.88, 95% CI 0.58 to 1.34) or rebleeding (OR 1.23) compared with later endoscopy, and was associated with more intensive care admission (OR 1.41). Results were consistent in high-risk patients. The EUROSTAR consensus from experts in ten European countries sets out eight statements and 13 recommendations on monitoring and managing symptoms after upper GI cancer surgery. A meta-analysis of 46 studies in 11,524 hospital nurses found HBsAg prevalence of 3.2%, higher in low- and middle-income countries, and inversely related to full vaccination. A 26-patient pilot trial found a fibre supplement in IBS on a low-FODMAP diet changed the microbiota and eased GI-specific anxiety without worsening symptoms. A single-cell study of rectal biopsies implicated TL1A signalling, active despite anti-TNF therapy, in perianal fistulising Crohn's disease.