This book describes Gastrointestinal Bleeding, Diagnosis and Treatment and Related Diseases
Gastrointestinal (GI) bleeding is any type of bleeding that begins in the GI tract.
GI bleeding is a symptom of a disease or disorder, rather than a disease or disorder itself.
Bleeding may occur from any location along the GI tract, but is often classified into:
- Upper GI bleeding (before the ligament of Treitz):
The upper GI tract involves the esophagus (the tube from the mouth to the stomach), stomach, and first part of the small intestine. - Lower GI bleeding (after the ligament of Treitz):
The lower GI tract involves much of the small intestine, large intestine or bowels, rectum, and anus.
Causes
GI bleeding may be due to disorders that are not serious, such as: - Anal fissure
- Hemorrhoids
GI bleeding may also be a sign of more severe diseases and disorders.
These may involve cancers of the GI tract such as: - Cancer of the colon
- Cancer of the small intestine
- Cancer of the stomach
- Intestinal polyps (a pre-cancerous condition)
Other causes of GI bleeding may include: - Abnormal blood vessels in the lining of the intestines (also called angiodysplasia)
- Bleeding diverticulum, or diverticulosis
- Crohn disease or ulcerative colitis
- Esophageal varices
- Esophagitis
- Gastric (stomach) ulcer
- Intussusception (bowel telescoped on itself)
- Mallory-Weiss tear
- Meckel diverticulum
- Radiation injury to the bowel
Peptic ulcer is the most widespread cause of upper GI bleeding.
Diverticular disease is the most frequent cause of lower GI bleeding
Most causes can be classified under:
1.Erosive or Inflammation e.g peptic ulcer, diverticular disease, esophagitis, colitis
2.Vascular rupture e.g Esophageal varices, Angiodysplasia
3.Tumors or cancers e,g gastric cancer or colon cancers, polyps
4.Others e.g. Aorto-enteric fistulas, radiation colitis
Symptoms
Gastrointestinal (GI) bleeding is a symptom of a disease in the gastrointestinal tract.
The blood often appears in stool or vomit but is not always visible, though it may cause the stool to look black or tarry.
The level of bleeding can vary from mild to serious and can be life-threatening.
Specialized imaging technology, when needed, can normally find the cause of the bleeding.
Signs and symptoms of GI bleeding can be either obvious (overt) or hidden (occult).
Signs and symptoms are dependent on the location of the bleed, which can be anywhere on the GI tract, from where it starts (the mouth) to where it ends (the anus) and the rate of bleeding.
Diagnosis
In order to diagnose GI bleeding, the doctor will first find the location of the bleeding.
Depending on the symptoms, the doctor will order one or more diagnostic tests to confirm whether the patient has bleeding in the GI tract.
The doctor will take a medical history, including a history of previous bleeding, conduct a physical exam and possibly order tests.
Blood tests
The patient may need a complete blood count, a test to see how fast the blood clots, a platelet count and liver function tests.
Stool tests
Nasogastric lavage
Gastroscopy
Colonoscopy
Capsule endoscopy
Endoscopy uses a tiny camera on the end of a long tube, which is passed through the mouth to enable the doctor to examine the upper gastrointestinal tract or the rectum to examine the colon.
Treatment
Treatment of bleeding in the GI tract is dependent on the cause or location of the bleeding.
GI bleeding can be an emergency situation that needs immediate medical care. - Blood transfusions.
- Fluids and medicines through a vein.
Endoscopy can diagnose and treat the bleeding
Often, GI bleeding stops on its own.
TABLE OF CONTENT
Introduction
Chapter 1 Gastrointestinal Bleeding
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Peptic Ulcer
Chapter 8 Diverticular Disease
Epilogue
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