"Gastrointestinal (GI) bleeding is a significant cause of disease and death throughout the world and in Pakistan we have an enormous share of this catastrophic problem," said Professor Mohammad Khurshid, Medical Director and Associate Dean Clinical Affairs, Aga Khan University Hospital (AKUH). He was speaking at a symposium on "State of the Art Management of Upper GI Bleeding" held on January 1, 2003, at Aga Khan University (AKU).

In his introductory remarks, Professor S.M.Wasim Jafri, Chief of Gastroenterology Section and Chairman, Department of Medicine, AKU, spoke on recent advances in the endoscopic management of GI Bleeding. He elaborated on the various endoscopic modalities available at AKUH to tackle this emergency. "Most GI bleeding problems demanding emergency surgical operations are handled easily by endoscopic skills which involve injection sclerotherapy, esophageal band ligation, ulcer sclerotherapy, argon plasma coagulation, heater probe, hemo clips and other therapeutic interventions. It is therefore critical that doctors are properly trained in endoscopic skills before carrying out interventional procedures," said Professor Jafri. A result of effective endoscopic management of GI bleeding, in those cases where surgical intervention is not mandatory, leads to a patients' hospital stay being shortened as well as fewer surgical complications. 

Dr.Shahab Abid, Assistant Professor, Department of Medicine, AKU, spoke on the initial management of a patient with upper GI bleeding, focusing on important aspects of patients' resuscitation and the availability of blood. Dr. Hasnain Ali Shah, Associate Professor, Department of Medicine, AKU, spoke about the management of variceal bleeding, very common in Pakistan due to the extreme prevalence of chronic liver disease as a result of Hepatitis B and C.

In his lecture on peptic ulcer bleeding, Dr. Saeed Hamid, Associate Professor, Department of Surgery, AKU, highlighted how to manage such an emergency and  discussed its endoscopic management as well as the role of resuscitation. Interventional radiology is most helpful in difficult cases of GI hemorrhage management. Dr. Tanveerul Haq, Assistant Professor, Department of Radiology, AKU, expanded on the role of a radiologist in such cases. Dr. Turab Pishori, Assistant Professor, Department of Surgery, AKU, enlightened the audience on how to manage a case of lower GI bleeding.                                                                                 

The final talk of the symposium was given by Ms. Doulat Hirani, Head Nurse, AKUH, regarding nursing considerations in the management of patients with GI bleeding. She highlighted "The importance of good nursing care in solving numerous problems and avoiding unnecessary complications in GI bleeding cannot be underestimated."

The talks were followed by a question and answer session and the inauguration of a GI Bleeding Unit This Unit will offer state-of-the-art management of gastrointestinal bleeding to patients admitted to AKUH. It will complement the other services currently available at the Hospital to treat gastroenterological problems.