Upper Digestive Bleeding – Causes And Diagnosis
Upper gastrointestinal bleeding is usually clinically manifested by haematemesis (vomiting blood) and melena (bloody stool). Therefore in practice this haematemesis and melena accompanied by symptoms and signs of internal bleeding is sufficient to affirm the existence of gastrointestinal bleeding. Rarely, a bleeding from the throat or a hemoptysis (coughing blood), followed by swallowing, can mislead the doctor. Whatever the source of bleeding, the blood during passage through the digestive tract becomes increasingly darker eventually gaining the appearance of melena.
The change in color of the blood present in the digestive tract due to a gastrointestinal bleeding depends on several factors including: location of bleeding, amount of blood lost,the speed with which bleeding occurs, and intestinal transit speed.
It is accepted that at least 60ml of blood is needed and it to remain at least 8 hours in the digestive tract, so that it might give the appearance of melena. If the transit is very fast a part of the blood from the gastrointestinal bleeding will be seen untransformed in the stool, as it happens in large hemorrhages caused by a duodenal ulcer for example.
Meckel diverticulitis bleeding can also cause red bloody stools. Melena stool may remain as such for several days after cessation of massive gastrointestinal bleeding. Changes in color of the vomit and stool, by various substances ingested (iron or bismuth salts, charcoal, different colors) can be excluded easily through patient questioning and the application of qualitative blood detection reactions, reactions that can be run very fast.
Diagnosis of gastrointestinal bleeding
If the patient presents no haematemesis or melena the diagnosis of gastrointestinal bleeding is based on clinical, laboratory signs of internal bleeding, anemia signs due to bleeding and the patient’s digestive disease history.
Symptoms of gastrointestinal bleeding that attract attention are: fatigue and weakness, installed more or less sudden or with a progressive nature, dizziness, fainting, nausea, instability in walking, anxiety, agitation, drowsiness, apathy, palpitations, thirst .
Patient examination with gastrointestinal bleeding: pale skin and mucous membranes, excessive sweating, hypothermia, hypotension, tachypnea, tachycardia, low reflection and other signs of internal bleeding.
Upper gastrointestinal bleeding causes
- Erosive and inflammatory ulcers
- Gastric ulcer
- Duodenal ulcer
- Stress ulcer
- Caustic injury bleeding
- Vascular Injury
- Esophageal and gastric varices
- Gastric antral vascular ectasia
- Portal hypertensive gastropathy
- Radiation-induced telangiectasia
- Gastric lymphoma
- Metastatic tumors