Management of Anticoagulant and Antiplatelet Agents in Acute Gastrointestinal Bleeding and Prevention of Gastrointestinal Bleeding

Gastrointest Endosc Clin N Am. 2024 Apr;34(2):205-216. doi: 10.1016/j.giec.2023.09.002. Epub 2023 Oct 5.


Managing gastrointestinal bleeding in patients using antithrombotic agents remains challenging in clinical practice. This review article provides a comprehensive and evidence-based approach to managing acute antithrombotic-related gastrointestinal bleeding, focusing on the triage of patients, appropriate resuscitation, and timely endoscopy. The latest clinical practice guidelines are highlighted to guide decisions concerning the use of reversal agents, temporary interruption, and resumption of antithrombotic drugs. Additionally, preventive measures are discussed to lower the risk of future bleeding and minimize complications among patients prescribed antithrombotic drugs.

Keywords: Anticoagulation; Antiplatelet agents; Bleeding prevention; Direct oral anticoagulants; Dual antiplatelet therapy; Endoscopy; Warfarin.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Anticoagulants* / adverse effects
  • Endoscopy, Gastrointestinal
  • Fibrinolytic Agents / adverse effects
  • Gastrointestinal Hemorrhage / chemically induced
  • Gastrointestinal Hemorrhage / prevention & control
  • Humans
  • Platelet Aggregation Inhibitors* / adverse effects


  • Anticoagulants
  • Platelet Aggregation Inhibitors
  • Fibrinolytic Agents