Acute upper gastrointestinal bleeding (adult UK pathway)
A source-linked educational visual of adult acute upper gastrointestinal bleeding resuscitation, risk assessment and endoscopy from NICE CG141 and BSG guidance.
Important safety note
This visual algorithm is an educational representation of published UK clinical guidance and is not a substitute for clinical judgement, local protocols, senior/specialist advice, or the original guideline. Verify current guidance before clinical use.
Scope and source
- Scope
- Adults with suspected acute upper gastrointestinal bleeding in UK emergency and acute-care services.
- Jurisdiction
- UK
- Primary guidance
- NICE CG141: Acute upper gastrointestinal bleeding in over 16s
- Guidance last updated
- 2016-08-24
- Clinical reference reviewed
- 2026-09-08
- Review due
- 2027-03-08
Interactive clinical algorithm
This source-backed visual algorithm is available in the interactive page experience. Open the original guidance and the node notes before clinical use.
How to read this visual
- Read across the columns for the phases of the pathway; the swimlanes are who acts — Emergency team, Bloods, scoring and transfusion, Endoscopy and interventional teams.
- Bold marks the dose, threshold or time limit that decides the next step; the rest of a label is context.
- Resuscitate before assigning an endoscopy timing branch.
- Open node notes for Glasgow-Blatchford thresholds, blood products and rebleeding escalation.
Clinical notes
- Use local major-haemorrhage, anticoagulant reversal and gastroenterology pathways.
- Discuss antiplatelet/anticoagulant interruption and restart with the relevant specialty.
Sources
- NICE CG141: Acute upper gastrointestinal bleeding (NICE; 2016-08-24)
- BSG-led multisociety consensus care bundle for early clinical management of acute upper GI bleeding (British Society of Gastroenterology; 2020-10-01)
Open an editable reference copy
Create a personal educational copy. Verify the original guidance before clinical use.