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Purposeof Review <p>The proportion of individuals ≥ 65 years of age in the global population is rapidly increasing. Gastrointestinal (GI) bleeding is one of the common GI conditions affecting older individuals. These individuals have unique comorbid conditions, exposures to anticoagulants or <i>Helicobacter pylori</i>, and physiologic changes that increase their propensity for developing ulcers or angioectasias, raise their bleeding risk, and affect their treatment plans. This review summarizes the epidemiology, pathophysiology, evaluation, and management of GI bleeding in older individuals.</p> Recent Findings <p>Frailty and increased use of anticoagulants and antiplatelet agents have negatively impacted GI bleeding outcomes. Novel risk scores have been developed to predict mortality, rebleeding, and need for endoscopic therapy. Several studies and guidelines have been published on timing of endoscopic interventions, strategies to prevent rebleeding, and peri-procedural anticoagulation management.</p> Summary <p>Older age is a risk factor for mortality in GI bleeding. Timely endoscopic evaluation and management of modifiable risk factors such as anticoagulation and <i>Helicobacter pylori</i> infection may mitigate bleeding risk in this population and reduce mortality.</p>

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Gastrointestinal Bleeding in the Older Adult: Pathophysiology, Evaluation, and Management

  • 期刊论文

  • 发表日期：

    2025年3月4日

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  • Zain A. Sobani,
  • Kenneth W. Hung

摘要

Purposeof Review

The proportion of individuals ≥ 65 years of age in the global population is rapidly increasing. Gastrointestinal (GI) bleeding is one of the common GI conditions affecting older individuals. These individuals have unique comorbid conditions, exposures to anticoagulants or Helicobacter pylori, and physiologic changes that increase their propensity for developing ulcers or angioectasias, raise their bleeding risk, and affect their treatment plans. This review summarizes the epidemiology, pathophysiology, evaluation, and management of GI bleeding in older individuals.

Recent Findings

Frailty and increased use of anticoagulants and antiplatelet agents have negatively impacted GI bleeding outcomes. Novel risk scores have been developed to predict mortality, rebleeding, and need for endoscopic therapy. Several studies and guidelines have been published on timing of endoscopic interventions, strategies to prevent rebleeding, and peri-procedural anticoagulation management.

Summary

Older age is a risk factor for mortality in GI bleeding. Timely endoscopic evaluation and management of modifiable risk factors such as anticoagulation and Helicobacter pylori infection may mitigate bleeding risk in this population and reduce mortality.