Contents
Gastrointestinal bleeding varies in severity, from occult bleeding (not visible to the naked eye) to haemorrhage, rapidly leading to hypovolemic shock. In the management of the patient, it is important to assess both the amount of blood lost and the source of bleeding. Symptoms of massive bleeding are pale skin, sweating, a fast heartbeat with a weak pulse, and a drop in blood pressure.
Bleeding from the gastrointestinal tract – symptoms
Bleeding from the upper gastrointestinal tract is evidenced by vomiting with blood or content similar to coffee grounds.
After 1-2 days, tarry and foul-smelling stool appears due to the bacterial breakdown of blood in the intestine. Much less often, the black stool may come from the small intestine or the right side of the colon. Tarry stools can also be a consequence of bleeding from Meckel’s diverticulum, in which blood comes into contact with hydrochloric acid produced by the ectopic gastric mucosa.
Causes of gastrointestinal bleeding
The most common causes of bleeding from upper section digestive tract are:
- peptic ulcers located in the stomach and duodenum,
- gastro-oesophageal varices,
- mucosal changes in the form of erosive gastritis or portal gastropathy.
Mortality in bleeding from the upper gastrointestinal tract is in the range of 3,5-7%.
Blood covering the stool is a symptom of bleeding from the colon, although it can also occur after heavy upper gastrointestinal bleeding.
The main causes of bleeding from lower section gastrointestinal tract include:
- angiodysplazje,
- haemorrhoids,
- tumors,
- diverticula,
- inflammatory bowel disease.
Mortality from acute lower gastrointestinal bleeding is estimated at 3,5%.
Diseases leading to haemorrhagic diathesis (eg Schönlein-Henoch disease, overdose of anticoagulant drugs) can cause mucosal bleeding from any part of the gastrointestinal tract.
Gastrointestinal bleeding diagnosis
The history of a patient bleeding from the gastrointestinal tract should refer to the several-month period preceding the bleeding and include information on the symptoms of dyspepsia, disturbances in the rhythm of bowel movements and changes in body weight. Patients should also be asked about alcohol abuse and the use of aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.
Spleen enlargement, ascites, gynecomastia or spider veins indicate esophageal varices (possibly gastric varices or portal gastropathy) as the cause of bleeding. In case of suspicion of liver disease or other bleeding disorders, it is necessary to measure the platelet count, bleeding time and prothrombin time.
If you notice problems with your digestive tract, purchase preventive examinations that will help determine their cause. On Medonet Market you will find, among others A package of tests for diseases of the digestive system. You can also perform a Dispatch test of the intestinal microflora and intestinal markers to check the quality of the microbiota and determine its resistance to harmful pathogens.
Source: Abdominal PHYSICAL TEST WITH ELEMENTS OF DIFFERENTIAL DIAGNOSTICS; Czelej Publishing House