Acute upper gastrointestinal bleeding in the elderly: aetiology, diagnosis and treatment.

Acute upper gastrointestinal bleeding (UGIB) is a common, potentially life threatening medical emergency. It is associated with higher rates of hospitalization, morbidity and mortality in the elderly when compared with younger patients, most likely due to higher prevalence of multiple comorbidities. Age is an independent risk factor for mortality in UGIB, with Helicobacter pylori infection and the use of non-steroidal anti-inflammatory agents and anticoagulants being the most prevalent causal risk factors. These patients require early risk assessment, resuscitation and an attempt to identify and treat the bleeding source. In the majority, this involves early endoscopy and endotherapy as required to achieve haemostasis, with radiological intervention or surgery needed in the minority with ongoing severe bleeding. In this article, we discuss UGIB in the elderly, focusing on aetiology, risk factors and management.