Gastrointestinal bleeding is not an independent disease, but a complication of many diseases of the gastrointestinal tract. Help with gastrointestinal bleeding should be provided as soon as possible and in full, as this terrible complication in severe cases it can lead to death.
Causes gastrointestinal bleeding
Cause gastrointestinal bleeding is damaged walls of the gastrointestinal tract involving small blood vessels or capillaries in any of its parts. The most frequent cause of gastrointestinal bleeding are the following diseases:
- Gastric and duodenal ulcers;
- Tumors are benign (polyposis) or malignant (cancer) in any of the gastro-intestinal tract;
- Varicose veins of the esophagus;
- Cracks esophageal mucosa;
- Cracks anus;
Gastrointestinal bleeding in children is most often caused by trauma of the esophagus or stomach, including chemical burns, as well as hemorrhagic disease of the newborn.
Types of gastrointestinal bleeding
Distinguish gastrointestinal bleeding of upper gastrointestinal tract, which includes the esophagus and stomach, and lower section consisting of the intestine.
Gastrointestinal bleeding in duration can be:
- Single (sporadic);
- Relapsed (recurred);
- Chronic (persistent).
By the nature of existence:
Symptoms of gastrointestinal bleeding
Common symptoms of gastrointestinal bleeding similar to the symptoms of blood loss at all. These include pale skin, weakness, tinnitus, cold sweat, tachycardia, shortness of breath, dizziness, flies before his eyes, lowering blood pressure. Pain or strengthening existing pain gastrointestinal bleeding are not peculiar.
Character same blood allocated depends on in what portion of the gastrointestinal tract was tampering with the blood vessel, and whether it is latent or apparent bleeding.
First, focus on obvious gastrointestinal bleeding.
Gastrointestinal bleeding from the upper GI manifest themselves vomit blood (hematemesis). Vomiting may contain unmodified blood, which is characteristic of bleeding from the esophagus, or look like coffee grounds, if bleeding occurred in the stomach, it gives a distinctive look to her blood, clotted under the action of hydrochloric acid. However, gastric arterial bleeding considerable force may also take the form of vomiting with unmodified blood, because the blood is not time to fold.
Gastrointestinal bleeding from the small intestine and colon can occur both as emesis "coffee grounds", and as melena - bloody diarrhea, having a tarry consistency and black. Melena may continue for several days after the cessation of bleeding in the upper gastrointestinal tract, tarry stool will stand out as you move the contents of the intestines.
If bleeding has occurred in the lower gastrointestinal tract (colon, rectum, anus), then it appears as a bloody stool (gematoheziya). In this case, feces contains impurity unchanged red blood, sometimes in significant quantities. However, sometimes bloody stool can be of considerable strength in bleeding in the small intestine, where due to the large amount of blood contents of the small intestine is moving very fast.
Hidden gastrointestinal bleeding found in laboratory studies of feces and gastric juice. Concealed bleeding from the upper gastrointestinal tract may appear as an admixture of black flakes in vomit, in all other cases, to the naked eye it quietly, and reveals itself only general signs of increasing anemia.
No significant difference in the manifestation of gastrointestinal bleeding in children and adults, a deficiency anemia in children is developing much faster, and because of the smaller capacity of the organism compensatory effects can be more dangerous.
First aid in case of gastro-intestinal bleeding
If there is severe bleeding, pre-medical first aid in case of gastrointestinal bleeding is as follows:
- As soon as possible to call an ambulance;
- Immediately put the patient to bed;
- Exclude delivery within the gastrointestinal tract of any substance, including water, food and drugs;
- Put on your stomach ice pack;
- Provide fresh air into the room where the patient lies;
- Provide constant supervision over them before the arrival of the ambulance, leaving no one.
First aid for gastrointestinal bleeding in children is not different from that of adults. It is important to ensure the child calm, which is somewhat more complicated than in the adult, especially if the child is small. If suspected gastrointestinal bleeding caused by trauma in children, it is necessary to try to determine as precisely as possible the traumatic factor (sharp object, chemical).
Emergency medical care in the gastro-intestinal bleeding depends primarily on the strength of his character and bleeding, and the patient's condition. In that case, if the bleeding of considerable strength, scarlet (arterial) blood, and it can not be stopped for a certain time by conventional means, the patient is brought to the emergency department of surgery.
Treatment of gastrointestinal bleeding
Treatment of gastrointestinal bleeding, depending on its nature, is carried out by means of surgical or conservative.
When bleeding considerable strength, if you can not stop the blood loss, resorted to emergency resuscitation techniques and surgery. Before the operation it is desirable to at least partially compensate for the amount of blood lost, which infusion therapy is performed by intravenous infusion of blood products or substitutes. In the case of threat to life possible emergency operation without such training. The operation can be carried out as a classic, open method and endoscopy (FGS, laparoscopy sigmoidoscopy, colonoscopy), depending on the evidence. Surgical treatment of gastrointestinal bleeding is a dressing veins of the esophagus and stomach, imposing sigmoidostoma, resection of the area of the stomach or intestines, damaged vessel coagulation, etc.
Conservative treatment of gastrointestinal bleeding consists of the following measures:
- Introduction styptic;
- The evacuation of the blood from the digestive tract through the introduction of a nasogastric tube and cleansing enemas (if bleeding from the lower GI);
- Restores blood loss;
- Support for vital body systems;
- Treatment of the underlying disease, leading to bleeding.