Published online Jan 7, 2016. doi: 10.3748/wjg.v22.i1.446
Peer-review started: July 30, 2015
First decision: August 31, 2015
Revised: September 11, 2015
Accepted: November 24, 2015
Article in press: November 24, 2015
Published online: January 7, 2016
Core tip: Alcoholism is highly prevalent worldwide and can cause advanced-alcoholic-liver-disease (aALD) from alcoholic hepatitis or cirrhosis. This work systematically reviews the literature on acute-upper-gastrointestinal-bleeding not directly related to portal hypertension in patients with aALD. Such patients have markedly increased risks of peptic ulcers, and worse outcomes from peptic ulcer bleeding than other patients, including refractory bleeding, rebleeding, and mortality. Such patients apparently have increased frequency and mortality of bleeding from Dieulafoy lesions. Such patients have more frequent, more severe, and more rebleeding from Mallory-Weiss-syndrome than non-cirrhotics. Prompt endoscopy, after resuscitation, is essential to diagnose and appropriately treat these patients, using endoscopic therapy when necessary.