Gastrointestinal bleeding: symptoms, first aid
Gastric hemorrhage is called a pathology in which blood enters the lumen of the stomach. This violation is a common cause of hospitalization. Usually, in medical practice use the term «gastrointestinal bleeding», which also understand the bleeding in the digestive tract, including the intestine. This article describes the main clinical manifestations of such bleeding and the principles of medical care.
There are many diseases that can be complicated by bleeding into the stomach or into the intestine, but most often they are the reason for getting peptic ulcer disease. Other common pathologies that lead to such bleeding, are the cancers with the processes of decay, diverticula, diaphragmatic hernia, polyps (benign character education), mucosal injury as a result of lengthy vomiting, the types of gastritis, which are accompanied by appearance of surface erosion, increased secretion of gastric juice under the influence of glucocorticoids (e.g., with strong stress). Gastric bleeding can also be provoked by vascular pathologies. Among them should indicate:
- Varicose vessels of the esophagus and the upper section of the stomach in cirrhosis and tumours of liver, chronic lymphocytic leukemia, compression of the portal vein.
- Systemic vasculitis autoimmune nature.
- Atherosclerosis and hypertension, which increases the probability of rupture of the blood vessels.
- In addition, the etiologic importance of disorders of blood coagulation. Most often bleeding in the digestive tract are recorded in hemophilia, acute and chronic leucosis, hemorrhagic diathesis, deficiency of potassium.
For gastrointestinal bleeding observed General symptoms, which are typical for hemorrhage at any site. These include weakness and a pronounced pallor of the skin, increased sweating and decreased blood pressure, pulse becomes frequent, but weak. Patients complain of dizziness and tinnitus. Unconscious patients confused, the reaction is sluggish, possible fainting. The greater the amount of bleeding, the brighter the clinical manifestations. When massive bleeding condition is deteriorating. If you do not help, perhaps a fatal termination.
To determine the source of the blood and diagnosis makes the correct laboratory and instrumental diagnosis, but some symptoms are specific, allowing time to suspect a bleeding:
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- Vomiting blood. If you vomit coffee grounds, it indicates bleeding in the stomach. This characteristic appearance is caused by the interaction of blood and hydrochloric acid. If the blood is bright red, it is from the esophagus, or it speaks of a massive hemorrhage of the arteries of the stomach (in this case, the blood does not react with hydrochloric acid, therefore, remains unchanged).
- The appearance of blood in the stool. Stomach bleeding tarry stools black color (called melena), which is also associated with the reaction of the digestive juices and blood. In the presence of fresh blood can be conclude that the bleeding from the intestines.
- Vascular collapse due to an abrupt loss of blood that is manifested by a sudden drop in blood pressure and tachycardia with thready pulse.
When developing acute internal bleeding of the stomach, General condition of the patient depends not only on the degree of blood loss, but also on its speed. The most unfavourable forecast was made with the rapid development of haemorrhage with loss of blood, which is ¼ of its total volume.
If a person records the symptoms of bleeding from the digestive tract, you need to act according to the following algorithm:
- to call an ambulance;
- lay the patient on his back with raised legs, to calm him down,
- prohibit to eat and drink, as this will only exacerbate the pathological symptoms;
- on the stomach, you can apply cold (e.g. ice) that will narrow the blood vessels and some slow the loss of blood;
- admission 1 teaspoon of 10% calcium chloride (it has styptic properties);
- it is strictly forbidden to do an enema or alone to wash out the stomach;
- if unconscious, the patient should be given the ammonia smell;
- before the arrival of doctors should monitor heart rate and breathing.
Features of therapy
Treatment in the acute phase involves probing and irrigation of the stomach with water of low temperature to remove blood that has accumulated, or a statement of an enema to cleanse the bowel. For the control of diuresis is carried out bladder catheterization. Also used oxygen therapy.
All therapeutic measures directed at hemostasis and infusion therapy, which helps to restore lost blood volume. During gastric lavage through the probe may be administered adrenaline. It causes vascular spasm and helps to reduce bleeding. Can also be used for endoscopic electrocoagulation or cauterization of the vessels with a laser, their firmware special thread or overlay clips from metal. If necessary, a suitable medical adhesive. In addition, for faster results, intravenous hemostatic drugs. The loss of a significant amount of blood to conduct blood transfusion and frozen plasma.
In cases where signs of gastrointestinal bleeding is increasing, and conservative methods do not help, resort to surgical therapy. As a rule, carried out the pathological closure of the site or deletion of some part of the stomach (sometimes the whole body).