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Mindfulness‐based stress reduction in patients with irritable bowel syndrome

admission, whereas the AASLD guidelines recommend endoscopy within 12 h of admission. We agree that rapid performance of endoscopy may improve outcomes and including a time frame for some treatments would be appropriate. We also agree that refinement of therapy can be done once a definitive diagnosis is established with endoscopy. However, there is usefulness of installing procedures (such as administration of antibiotics) expediently prior to EGD regardless of the source of upper gastrointestinal haemorrhage. As Dr Kiong correctly points out that excessive fluid resuscitation in variceal haemorrhage should be avoided; however, we disagree over the importance of achieving normal PT ⁄ PTT and platelet levels in these patients. Although normalising these parameters may be of importance in other types of upper gastrointestinal bleeding, we feel it is unnecessary and unrealistic to have goals of 100 000 platelets and normal PT in patients with variceal haemorrhage.