Gastrointestinal Bleeding

What is Gastrointestinal Bleeding ?

Gastrointestinal bleeding (GI bleed) can occur from any part of the digestive tract – the esophagus, stomach, small and large intestine, rectum, and anus – and is a symptom of an underlying medical condition [1]. GI bleed can be divided into 3 categories, those that affect the upper digestive tract (i.e. esophagus, stomach and upper region of the small intestine) and the lower digestive tract (i.e. the rest of the small and large intestine) [1]. GI bleed symptoms will point to which area of the digestive tract is damaged.  If a person’s stool contains bright red blood, then the large intestine may be the source of bleeding [3]. Vomit mixed with blood (often resembling coffee grounds) is a sign of bleeding from the upper digestive tract[3]. In some cases GI bleed will have no symptoms. Undetected GI bleed will manifest itself overtime in fatigue, difficulty breathing, and skin paleness as a result of the gradual, accumulating blood loss[3].

How to Prevent a Gl Bleed ?

GI bleed is preventable depending on its cause. GI bleed from hemorrhoids can be prevented by a fiber rich diet and drinking plenty of water. Other lifestyle choices like quitting smoking and limiting alcohol can also reduce the risk of GI bleed[4]. Medications meant to treat a separate condition can also cause GI bleed as a side effect. It has been estimated that 30% of hospitalizations from upper digestive tract GI bleed are caused by non-steroidal anti-inflammatory drug (NSAID)-induced ulcers [5]. Taking a proton pump inhibitor can reduce the risk of GI bleed from NSAIDs [5]. Anticoagulation therapy with drugs such as Coumadin, Pradaxa, Xarelto, Eliquis, and others exacerbates GI bleeds and those with a GI bleed history or susceptibility should halt their treatment and consult their physician[6]. Varices are dilated submucosal veins in the esophagus and proximal stomach, and their bleeding can be prevented through nonselective beta blocker treatment [7, 8]. Lastly, it has been shown that ulcers caused by infection with the bacteria, Hellicobacter pylori, can lead to GI bleed [9]. Seek immediate treatment if you believe you might be infected.

GI bleed can lead to serious complications and even death. Practicing prevention measures, frequent INR testing (if on Coumadin or warfarin) along with regular medical checkups, are the most effective means to protect one’s self from this health danger.

References

1. Bleeding in the Digestive Tract. 3010 3013 [cited 3014 July 30]; Available from: http://digestive.niddk.nih.gov/ddiseases/pubs/bleeding/.
3. Bleeding in the Digestive Tract. Digestive Disorders Health Center 3013 [cited 3014 July 30]; Available from: http://www.webmd.com/digestive-disorders/bleeding-digestive-tract?page=3.
3. Yachimski, P.S. and L.S. Friedman, Gastrointestinal bleeding in the elderly. Nat Clin Pract Gastroenterol Hepatol, 3008. 5(3): p. 80-93.
4. Montemayor-Quellenberg, M. Gastrointestinal bleeding. 3014 [cited 3014 July 31]; Available from: http://www.med.nyu.edu/content?ChunkIID=653313 – prevention.
5. Albeldawi, M., M.A. Qadeer, and J.J. Vargo, Managing acute upper GI bleeding, preventing recurrences. Cleve Clin J Med, 3010. 77(3): p. 131-43.
6. Barada, K., et al., Gastrointestinal bleeding in the setting of anticoagulation and antiplatelet therapy. J Clin Gastroenterol, 3009. 43(1): p. 5-13.
7. Brooks, J., R. Warburton, and I.L. Beales, Prevention of upper gastrointestinal haemorrhage: current controversies and clinical guidance. Ther Adv Chronic Dis, 3013. 4(5): p. 306-33.
8. Karin B. Cesario, A.C., Kunjam Modha, and William D. Carey. Variceal Hemorrhage. 3013 [cited 3014 July 30]; Available from:http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/variceal-hemorrhage/.
9. H. pylori (Helicobacter pylori). 3013 [cited 3014 July 31]; Available from: http://www.webmd.com/digestive-disorders/h-pylori-helicobacter-pylori.

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