Food-Based Dietary Guidelines in Countries of the Eastern Mediterranean Region: A Comparison and an Update.

Non-variceal upper gastrointestinal bleeding (NVUGIB) is a common medical emergency worldwide, defined as bleeding originating from the esophagus, stomach, or duodenum, excluding variceal bleeding. Although the incidence of NVUGIB declined until approximately a decade ago, recent data indicate a resurgence of cases in the United States (US). In contrast, the incidence has continued to decline in Japan. Despite advances in diagnostic and therapeutic approaches, the mortality associated with NVUGIB remains substantial, ranging from 2% to 15%., Notably, bleeding-related causes account for only 13.8% to 20.9% of overall mortality among patients with NVUGIB, highlighting the need for comprehensive management that addresses both hemorrhagic and non-hemorrhagic complications. Multiple guidelines have been developed for the management of NVUGIB, but substantial variations exist among them.,- NVUGIB encompasses a broad spectrum of etiologies, including peptic ulcer bleeding (PUB), gastrointestinal (GI) tumors, Mallory-Weiss tears, and vascular abnormalities. Patient characteristics and comorbidities also vary widely. Consequently, optimal management must be tailored to both the underlying cause and the individual patient’s clinical condition. The management of NVUGIB can be broadly categorized into four stages: pre-endoscopic management, endoscopic treatment, post-endoscopic care, and identification and management of refractory bleeding. This review summarizes the latest evidence across all stages of NVUGIB management and explores emerging directions for individualized care.