Gastrointestinal Hemorrhage

Gastrointestinal Hemorrhage General Information

Gastrointestinal Hemorrhage, a medical condition also known as gastrointestinal bleeding represents every type of blood loss (hemorrhage, bleeding) that occurs in the gastrointestinal tract, meaning from the region of the pharynx to the rectum. There are many different causes that can lead to the appearance of this serous medical disorder. The main forms of Gastrointestinal Hemorrhage are distinguished after finding out the essential information about the medical history of the patient and after a closely physical examination by a physician. The bleeding can have various degrees; some of them are nearly undetectable, being not very severe, but some can become a real threat to the individual’s life because they are more massive and involve acute health conditions. When we talk about this medical condition we must precise that there are two main types of Gastrointestinal Hemorrhage; scientists have divided it into two major clinical syndromes: lower gastrointestinal bleeding and upper gastrointestinal bleeding. The lower gastrointestinal bleeding can be detected when a few amount of red blood is eliminated through the rectum, especially when hematemesis (a medical condition described as vomiting up blood) is absent. In this case, isolated melana (a medical condition characterized by the presence of altered blood in a tarry stool) can develop anywhere between the stomach and the first part of the colon. When a person is suffering from upper gastrointestinal bleeding, the hemorrhage will appear somewhere between the pharynx and the ligament of Treitz; in this case, the source of bleeding can be characterized by melana and hematemesis.

Gastrointestinal Hemorrhage Symptoms

The signs and symptoms specific for this medical condition-Gastrointestinal Hemorrhage can vary from mild to severe (that could be even life-threatening). The amount of blood can be that small that to be detected it by the health care provider he or she must order laboratory testing. This is called a microscopic bleeding and can be observed in the form of iron deficiency anemia. A slow and gradual bleeding may pass unobserved and it may be noticed only when the respective person starts to feel tired and undergoes anemia testing. Massive bleeding can also occur; big amounts of pure blood are passed; shock and hypovolemia can be developed by any patient if the doctor does not apply the proper treatment in due time. In these extreme cases, the patients present an increased risk of death. The exact percentage of people affected by Gastrointestinal Hemorrhage is not known for sure. The lower type of this medical condition is the most common and the patients do not need hospitalization all the time. Other signs and symptoms that could be experienced by some of the patients are hematochezia (specific for the upper gastrointestinal bleeding and showing that significant amounts of blood were loss), heartburn, hematemesis or melana. If the cause for this medical disorder is the duodenal ulcers, then the patients may experience epigastric pain only after three or four hours after a meal. If the patients suffer from a penetrating ulcer, then this type of pain is more intense and it could radiate to the back area.

Gastrointestinal Hemorrhage Treatment

If you suffer from Gastrointestinal Hemorrhage it is very important to talk to your health care provider about the risks that this medical condition has and about the possible causes that determined the appearance of this disease in order to be more careful in the future and to avoid it from recurring. After a close and careful physical examination by a specialist, the exact cause of Gastrointestinal Hemorrhage must be determined in order to proceed as soon as possible with an adequate and prompt treatment. The precise source of this medical condition can be identified by doing a colonoscopy or an upper endoscopy. These exams may be very useful in therapeutic interventions. The main aim of any therapy against this medical disorder known as Gastrointestinal Hemorrhage is to resuscitate the patient by administrating intravenous (IV) fluids through infusion or by doing a blood infusion to the respective person. This process must be preformed before proceeding with any further intervention because this one may be precluded by the presence of shock or intravascular depletion. Then, a therapy with prompt pump inhibitors (when the health care provider deals with an upper source that caused the GI) may be used because it enhances the healing of the bleeding lesions and reduces the production of gastric acids; as well, tranexamic acids (a procedure called the inhibition of fibrinolysis) can be applied if the person has an ongoing bleeding because this procedure has important effects in reducing the fibrinolysis and it decreases the requirements of blood products.

For a patient suffering of Gastrointestinal Hemorrhage it is very important that his or her portal pressure should be reduced. In this matter, when the bleeding is due to some complications that occur in the cirrhosis of the liver (a medical condition called esophageal varices), the therapy is done using analogues of the vasopressin (a hormone also known as ADH) and more rarely, octreotide or a Sengstaken-Blakemore tube that compresses the varices. If the parameters of coagulation, for example the prothrombin time are deranged, the correction of coagulopathy must be done immediately with fresh frozen plasma or by administrating vitamin K. If the patient suffers from a severe stage of Gastrointestinal Hemorrhage that can not be managed medically, then the health care providers will do an urgent endoscopy called esophago-gastro-duodenoscopy or EGD (OGD, in the British medical dictionaries) in order to identify the sources of the hemorrhage. This is a procedure considered to submit the patient to a high risk. It must be performed in operating theatres or in an intensive care unit, under safe circumstances. If the case of bleeding is extreme, really severe, then the health care provider can demand a laparotomy that will identify the source of bleeding. In the cases that the nonoperative procedures were inefficient, unavailable or unsuccessful and if the person continues to bleed, the surgical approach must be considered. More than 15% of the patients suffering from a lower gastrointestinal bleeding need this emergency operation. This procedure is risky because the mortality rate is between 1 and 20 per cent.