Gastrointestinal bleeding

Gastrointestinal bleeding is not an independent disease, but a complication of many diseases of digestive tract. Help at gastrointestinal bleeding has to be given as soon as possible and in full as this terrible complication, in hard cases it can lead to a lethal outcome.

Reasons of gastrointestinal bleeding

Damage of a wall of digestive tract with involvement of a blood vessel or small capillaries on any of its sites is the reason of gastrointestinal bleeding. Causal gastrointestinal bleeding the following diseases are the most frequent:

• Stomach ulcer and duodenum;
• Hemorrhoids;
• Tumors, both high-quality (polyposes), and malignant in any of departments of digestive tract;
• Gullet varicosity;
• Cracks of a mucous membrane of a gullet;
• Cracks of an anal orifice;

Gastrointestinal bleeding is most often caused in children by an injury of a gullet or stomach, including a corrosive burn, and also a hemorrhagic disease of newborns.

Types of gastrointestinal bleeding

Distinguish gastrointestinal bleeding from an upper part of digestive tract to which the gullet and a stomach, and the lower part consisting of intestines belong.

Gastrointestinal bleeding on duration can be:

• Single (incidental);
• Recurrent (periodically renewing);
• To chronic (constants).

In a form:

• Acute;
• Chronic.

On the nature of manifestation:

• Hidden;
• Explicit.

Symptoms of gastrointestinal bleeding

The general symptoms of gastrointestinal bleeding are similar to blood loss symptoms in general. Pallor of integuments, weakness, a sonitus, cold sweat, tachycardia, an asthma, dizziness, front sights before eyes, a lowering of arterial pressure concern to them. Pain, or strengthening of already available pain are not inherent to gastrointestinal bleeding.

Character of the most emitted blood depends on in what site of digestive tract there was a disturbance of integrity of a blood vessel, and from that, the concealed this hemorrhage or explicit.

In the beginning we will stop on explicit gastrointestinal bleedings.

Gastrointestinal bleedings from an upper part of a GIT prove a hematemesis (hematemesis). Vomiting may contain not changed blood that is peculiar to bleedings from a gullet, or to have an appearance of a coffee thick if bleeding occurred in a stomach, the characteristic look to it is given by the blood which turned under the influence of hydrochloric acid. However gastric arterial bleeding of significant force can also have a vomiting appearance with not changed blood as blood at the same time does not manage to be turned.

Gastrointestinal bleeding from a small intestine and a colon can be shown as in the form of vomiting by "a coffee thick", and in the form of a melena – the bloody diarrhea having a tar-like consistence and black color. The melena can proceed some more days after the termination of bleeding in an upper part of digestive tract, tar-like the kcal will be allocated in process of advance of contents on intestines.

If bleeding occurred in a lower part of digestive tract (a large intestine, a rectum, an anus), then it is shown as a bloody chair (gematokheziya). In this case the kcal contains impurity of invariable scarlet blood, sometimes in significant amounts. However the bloody chair can sometimes be also at bleeding of significant force in a small intestine when because of a large amount of blood contents of a small intestine move very quickly.

The concealed gastrointestinal hemorrhages are found at laboratory researches a calla and a gastric juice. The concealed hemorrhage from upper parts of a GIT can look as impurity of black flakes in vomiting, in all other cases to a naked eye it is imperceptible, and proves only the general symptoms of the accruing anemia.

There is no special difference in display of gastrointestinal bleedings at children and at adults, only anemia at children develops much quicker, and because of smaller compensatory opportunities of an organism of an effect can be more dangerous.

First aid at gastrointestinal bleeding

If there was acute bleeding, pre-medical first aid at gastrointestinal bleeding is as follows:

• As soon as possible to call the ambulance;
• To immediately put the patient to bed;
• To exclude receipt in digestive tract of any substances, including water, drugs and food;
• To put on a stomach a bubble with ice;
• To provide access of fresh air to the room where the patient lies;
• To provide constant observation of it before arrival of ambulance, without leaving one.

First aid at gastrointestinal bleeding at children does not differ from that at adults. It is important to provide to the child rest that it is slightly more difficult, than at the adult, especially, if the small child. If presumably gastrointestinal bleeding is caused in children by an injury, it is necessary to try as it is possible to define more precisely the injuring factor (a sharp object, chemical).

The emergency medical assistance at gastrointestinal bleeding depends first of all at most bleeding and its character, and also on a condition of the patient. If bleeding of significant force, with scarlet (arterial) blood, and he does not manage to be stopped during certain time usual means, the patient is brought to department of the emergency surgery.

Treatment of gastrointestinal bleeding

Treatment of gastrointestinal bleeding, depending on its character, is carried out by surgical or conservative means.

At bleedings of significant force if it is not possible to stop blood loss, resort to resuscitation techniques and an immediate surgery. Before operation it is desirable to fill at least partly the volume of the lost blood for what carry out infusional therapy, by intravenous injection of blood preparations or its substitutes. In case of threat of life urgent operation without similar preparation is possible. Operation can be performed as a classical, open method, and endoscopic (FGS, a laparoscopy a rektoromanoskopiya, a kolonoskopiya), depending on indications. Operational treatment of gastrointestinal bleeding consists in bandaging of veins of a gullet and stomach, imposing of a sigmostoma, resection of the site of a stomach or a gut, coagulation of the damaged vessel, etc.

Conservative treatment of gastrointestinal bleeding consists of the following events:

• Introduction of styptic means;
• Evacuation of blood from a GIT by introduction of the nazogastralny probe and cleansing enemas (if bleeding not from a lower part of a GIT);
• Completion of blood loss;
• Support of the vital systems of an organism;
• Treatment of the basic disease which led to bleeding.