Endoscopy is the gold standard for diagnosing and treating an upper GI haemorrhage. The timing of endoscopy is important, and should take place only after the patient is adequately resuscitated. Common therapies include injection or thermal therapy for a bleeding peptic ulcer, or banding of oesophageal varices.

Endoscopy controls bleeding initially in around 90% of patients with bleeding peptic ulcers [PALMER]. Mallory-Weiss tears normally stop without endoscopic intervention.

Patients should be clinically assessed and risk stratified using scoring systems to help determine how urgently endoscopy should be performed and to what level of care facility they should be admitted.

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High-risk bleeds need urgent endoscopy, both for diagnosis and therapy.