UGIB-Pre-endoscopy Prokinetic — ESEGH MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: B — Erythromycin IV 250 mg infusion given 30–120 minutes pre-endoscopy
Erythromycin IV (250 mg infused 30–120 minutes pre-endoscopy) is strongly recommended by ESGE for patients with clinically severe or ongoing active nonvariceal UGIB. High-quality evidence demonstrates that pre-endoscopic erythromycin infusion significantly improves endoscopic visualization, reduces the need for second-look endoscopy, decreases transfusion requirements, and shortens hospital stay. Recent network meta-analysis confirms erythromycin provides superior endoscopic visualization outcomes compared to metoclopramide or placebo. Metoclopramide (A) lacks sufficient high-quality evidence and does not provide significant visualization benefit over control. Octreotide (C) is reserved for variceal bleeding, not nonvariceal UGIB. H2-blockers (E) address acid suppression but do not improve visualization. No adjunctive agent (D) is suboptimal when erythromycin is available and indicated.
Reference: ESGE Guideline: Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage, Gralnek IM et al., Endoscopy 2021; 53, https://www.esge.com/assets/downloads/pdfs/guidelines/2021_a_1369_5274.pdf