Impact of Diagnostic and Therapeutic Upper and Lower Gastrointestinal Endoscopic Management on Critically Ill Patients in Fayoum University Hospitals

Inclusion Criteria: * Critically ill Patients with overt gastrointestinal bleeding * Critically ill Patients with suspected gastrointestinal bleeding manifestations as: * Acute and unexplained anemia * Sudden unexplained hemodynamic instability * Prolonged Ryle feeding (10 days) * Prolonged intubation (7 days) * Prolonged hospitalization with occult blood in stool * Prolonged administration of anticoagulants (2 weeks) * Prolonged PPI treatment and history of peptic ulcer * Critically ill Patients with other indications as: * Immunocompromised patients with oral candidiasis * Persistent unexplained vomiting * Dysphagia and odynophagia * Intractable or chronic gastro esophageal reflux disease * Chronic unexplained diarrhea * Unexplained Iron deficiency anemia in old age * Suspicion of malignant ulcer (peptic or colonic) * Cancer of unknown origin * Duodenal biopsy * Suspicion of colonic mass Exclusion Criteria: * Patient refusal * Noncompliance * Facial trauma * Patient age less than 18 years old