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Hidden intestinal bleeding. Gastrointestinal bleeding

A disease in which blood leaks from the vessels of the stomach. Gastric bleeding is a complication of pathological conditions of the body. In some cases, it is caused by damage to the coagulation system or other body systems.

The etiology of the disease is associated with ulcerative lesion stomach. However, other reasons are now being identified stomach bleeding. Among them, medications play a major role.

This pathological process is associated with taking medications, mainly in large quantities. Moreover, spontaneously, without a doctor’s prescription. Which undoubtedly leads to these lesions of the gastric mucosa.

Although there are also side effects taking medications. But this fact is predicted much less often. What happens to the stomach? First of all, they are formed medicinal erosions and ulcerations of the gastric mucosa.

The patient is sent to emergency hospitalization. Since the issue of increasing mortality among patients is very relevant. Mortality is observed in 25% of cases.

The cause of the disease may be related to chronic pathologies. Among them, chronic renal failure. It is this pathology that leads to damage to the gastric mucosa. Ulcers form and bleed.

Stomach damage also occurs against the background of other diseases. Among other diseases are stressful situations. That is, during periods of strong emotional stress, the gastric mucosa suffers. The causes of the disease include:

cardiovascular pathologies;
cirrhosis of the liver;
thermal injuries;
malignant neoplasms

Traumatic brain injuries, heart attacks, and hypothermia can also provoke gastric bleeding. It is also important to note that treatment of gastric bleeding should be aimed at a course of anti-Helicobacter therapy.

Patients who have not completed this course of treatment are at risk of recurrent gastric bleeding. Which is a fairly significant factor in the disease. Elderly people are at greater risk of death from this disease. And also people with various pathologies internal organs.

Symptoms

In many ways Clinical signs diseases depend on the intensity of bleeding. And also on the duration of the disease. Therefore, symptoms are characterized depending on the type of bleeding.

Bleeding is divided into several groups according to intensity. This can be short-term bleeding, moderate intensity and significant hemorrhage. Also noted chronic stage gastric bleeding.

General symptoms of the disease are quite common in this case. May manifest themselves quite acute course diseases. Or a constant chronic process. What is the most serious complication. Note:

The most intense blood loss is characterized by impaired consciousness. This is the most dangerous period of the disease. Shock may occur. Or the patient may fall into coma. Profuse bleeding leads to death.

With short-term bleeding, the situation is not life-threatening. But the patient feels dizzy. Which is also a significant sign of bleeding. May be a consequence severe stress. However, it may be associated with uncontrolled use medications.

With moderate bleeding, blood accumulates in the stomach cavity. Vomiting may occur. This is the most common sign of moderate bleeding.

If the bleeding is intense, loss of consciousness may occur. Mainly develops hemorrhagic shock. Ultimately, death can occur if proper care is not provided.

Diagnostics

Great importance Diagnosis of the disease involves taking an anamnesis. It assumes the presence of certain information about the disease. As well as possible causes of this disease.

Also in the diagnosis of gastric bleeding is an examination of the patient. Presence of complaints. There is pallor and cold sweat. The patient should consult a gastroenterologist.

In the diagnosis of gastric bleeding, the collection method is used clinical tests. This involves a detailed blood test. That is, the level of hemoglobin and red blood cells is directly determined.

Stool analysis is widely used occult blood. This allows you to detect internal bleeding. If there is blood in the stool, then we can talk about gastric bleeding.

A blood clotting disorder is detected. As well as a decrease in hemoglobin levels. With significant bleeding, the hemoglobin level is very low.

The most accurate diagnosis is gastroscopy. That is, endoscopic examination of the stomach using a gastroscope. It is very advisable to carry out this particular procedure. This method allows you to detect significant dilation of the veins of the esophagus and stomach.

For research possible reasons gastric bleeding using ultrasound diagnostic method. This allows us to identify different pathological conditions internal organs. In this case they use ultrasound diagnostics abdominal organs.

Prevention

How can you prevent stomach bleeding? Prevention of gastric bleeding involves treating the underlying disease. The disease that led to these complications.

For early diagnosis underlying disease, it is advisable to visit a doctor. Once a year is best. Must be passed necessary tests. Laboratory and clinical research.

Diseases that need to be cured on time include gastric ulcers, diseases gastrointestinal tract, diseases of the blood systems. Specific treatment therapy must be applied.

At peptic ulcer stomach, it is advisable to conduct a course of anti-Helicobacter and antisecretory therapy. What is enough effective treatment in this case. But only after consultation with a therapist or gastroenterologist.

However, treating the underlying disease is not enough. Prevention will consist of healthy way life. It is necessary to play sports. Do not smoke or drink alcohol in excess.

Bad habits can also cause illness. When taking medications, you must follow the instructions. Do not self-medicate. Taking medications according to doctor's instructions!

It is also necessary to avoid serious stress. Severe emotional stress can cause the formation of ulcers in the gastrointestinal tract. Psychosomatic pathology often occurs!

Psychosomatic pathology is associated with the psyche and body. Mind and body are interconnected criteria of health. Therefore, if the soul suffers, then the body also suffers.

Treatment

If the bleeding is minor or moderate, then in any case it is better to carry out medical therapy in a hospital setting. In this case, conservative treatment is prescribed. It is aimed at stopping bleeding.

Conservative technique involves the use of hemostatic agents medicines. This is most appropriate in this case. Certain medications are prescribed to treat anemia.

This group of drugs is aimed at replenishing iron deficiency during bleeding. If there is heavy bleeding, the patient is urgently hospitalized. In this case they use surgical methods stop bleeding.

If the gastric bleeding is profuse, then the patient needs rest. Blood transfusion is performed. It ensures replenishment of blood loss. The following components are poured:

plasma;
cryoprecipitate;
red blood cells

It is advisable to apply cold to the bleeding area. An ice pack is usually used in this case. After the necessary courses of medical therapy, stitching of the stomach ulcer is used. In some cases, gastric resection is required.

In adults

Stomach bleeding in adults can be the most dangerous. Especially in old age. In some cases it may end fatal. In young and middle-aged people, with adequate therapy, the process can result in recovery.

At risk for fatalities there are people over sixty years old. This is due to impaired hemostasis. In old age, the functions of internal organs are also weakened.

Elderly people with various health conditions are especially at risk. It could be a trivial arrhythmia and hypertension. Which is a common occurrence in this category of patients. The risk group includes people with the following disorders:

bradycardia;
tachycardia;
hypotension;
chronic kidney failure;
cardiovascular pathology

Acute and chronic manifestations of gastric bleeding occur among the adult population. Acute bleeding is manifested by a number of signs. Chronic bleeding can be hidden.

With obvious bleeding, diagnosis is greatly facilitated. However, there are signs of obvious bleeding on the face. The most common signs:

bloody vomiting;

With chronic bleeding, diagnosis becomes more complicated. That is, one can only suspect this pathology. It is advisable to conduct a clinical diagnosis. Namely, a stool test for occult blood.

In children

Gastric bleeding in children requires urgent hospitalization. The main causes of this pathology in children are associated with gastric ulcers. A burn can cause gastric bleeding. Chemical or mechanical burn, depending on the exposure factor.

Also in the etiology of this disease in children is a blood disease. It could be genetic disease. Or an acquired blood pathology. Let's say leukemia or hemorrhagic vasculitis.

What are the main signs of gastric bleeding in children? The main symptoms include vomiting and anemia. Bleeding may be accompanied by:

dizziness;
dry mouth;
increased thirst;
pallor;
tachycardia

Newborns may experience prolonged bleeding. Moreover, it is spontaneous, independent of certain factors. What is most dangerous in childhood. Especially during the newborn period.

A common cause of stomach bleeding in children is ulcerative gastritis. Or pathology of the esophagus. With ulcerative gastritis, stress occurs, poor nutrition. And this is the most dangerous disease. Requires urgent hospitalization!

Forecast

For stomach bleeding, the prognosis is different. Depending on the age of the patient, as well as on the intensity of bleeding. The worst prognosis is usually observed with significant bleeding. There is a hidden nature of bleeding.

Also, the prognosis for chronic bleeding is poor. Since chronic bleeding is often accompanied undercurrent. In this case, it is necessary to provide proper assistance.

A favorable prognosis is usually with mild gastric bleeding. There is also a young age of the patient. If this old man, then the worst prognoses often occur.

Exodus

Stomach bleeding can end unfavorably. The patient may fall into a comatose state. And this is directly related to the intensity of bleeding and the timeliness of treatment.

Only when timely treatment positive trends are observed. Until recovery. If the patient begins treatment on time, the outcome is favorable. Especially with surgery followed by symptomatic therapy.

An unfavorable outcome is associated with the occurrence various complications. With hemorrhagic shock or coma. Which undoubtedly leads to mortality among patients.

Lifespan

As mentioned above, life expectancy with gastric bleeding increases if there is timely diagnosis and treatment. In people of average and young more chances for recovery. Their life expectancy increases with adequate therapy.

If at acute bleeding If no help is provided, the patient often dies from shock. Chronic bleeding also occurs. With chronic bleeding, life expectancy is reduced. Since chronic bleeding has a number of consequences.

Remember, only adequate curative therapy underlying disease will undoubtedly prolong your life! Treat diseases on time, this will help avoid unwanted consequences! Be healthy!

Gastrointestinal intestinal bleeding represented by the release of a certain amount of blood by vessels damaged by pathology or erosion directly into digestive organs. Depending on the degree of blood loss and its subsequent localization, the following clear signs may appear:

tarry or black stool;
vomiting, the consistency of which resembles coffee grounds;
tachycardia;
cold sweat;
pallor and dizziness;
fainting and general weakness.

Diagnosis of the described disease is carried out through colonoscopy, enteroscopy, and laparotomy. As for stopping bleeding, it is carried out surgically or conservatively.

In fact, gastrointestinal bleeding is a complication of chronic or acute diseases that affect the digestive organs. In most cases, it poses a clear threat to human life. The source of such an undesirable phenomenon can be the large or small intestine, stomach, esophagus, etc.

Causes

Gastrointestinal bleeding can be ulcerative or non-ulcerative. The first group includes:

Recurrent ulcers after resection of part of the stomach.
Numerous slit-shaped ulcers of the large and small intestines that appeared against the background severe inflammation(Crohn's disease).
Ulcerative nonspecific colitis.

Malignant and benign tumors usually form in the transverse colon, or rather, in its descending section.

The second group includes:

cracks found in the rectum;
against the background of exacerbation;
diverticula in the intestine.

Causes of bleeding

Besides stated reasons, feces mixed with blood are found in infectious diseases of the intestines, for example, tuberculosis, dysentery, and typhoid fever.

Symptoms

First and alarming symptom, indicating gastrointestinal bleeding, is blood detected during bowel movements or passed on its own. Usually at the very beginning of the disease it is not released. It is important to take into account the color change feces while taking activated carbon, medications containing iron. Some foods also lead to a similar change, it could be pomegranate, chokeberry, blueberries, black currants.

Signs of bleeding from the gastrointestinal tract

It must be remembered that such a change in children occurs against the background of ingestion of sputum or blood during nosebleeds, and in adults - during pulmonary bleeding.

The degree of bleeding in the gastrointestinal tract is detected by the first signs:

sharp;
pale skin;
"floaters" in the eyes, dizziness.

The etiology of this disease varies and manifests itself individually against the background of a particular diagnosis. The main symptoms of gastrointestinal bleeding are represented by the following factors:

Cancer of the rectum or colon leads to chronic anemia, the discharge of blood is not strong. Therefore, malignant tumors are often discovered as a result of examination of a person with anemia. Stool mixes with blood and mucus if the tumors are located on the left side of the large intestine.
Ulcerative nonspecific colitis causes the patient to have a frequent urge to have false bowel movements. The stool becomes watery, and an admixture of mucus, pus, and blood is detected. Against the backdrop of a long similar condition there is a risk of developing anemia.
The presence of hemorrhoids is indicated by bleeding during bowel movements or sudden physical activity, the discharge has a characteristic scarlet color. Stool usually does not mix with blood. Other signs of this disease include pain in the anus, burning, and severe itching.

Symptoms of the disease in children

Gastrointestinal bleeding in children in most cases occurs before the age of three. May appear congenital pathologies as:

partial infarction of the large intestine associated with obstruction or volvulus;
doubling small intestine;
ulcerative necrotizing enterocolitis.

In this case, the child has pronounced bloating, constant vomiting and regurgitation. Greenish stool mixed with blood and mucus. In the gastrointestinal tract - acute bleeding.

What to do if you notice symptoms of the disease

Pre-medical first aid for gastrointestinal bleeding consists of several important points:

calling an ambulance;
positioning the patient strictly in horizontal position with legs slightly raised;
preventing the entry of any substances (food, water, medications) into the body;
fixing a heating pad with ice on the stomach;
availability of fresh and cool air in the room;
regular monitoring of the patient.

If we talk about providing emergency care for internal bleeding in children, it is practically no different. The situation is complicated by the fact that it is much more difficult to calm a baby than an adult. If the disease is caused by injury, it is necessary to describe the traumatic factor to the doctor as accurately as possible. It could be Chemical substance, sharp object, etc.

Regarding emergency services medical care, it directly depends on the nature and strength of the bleeding, on the general condition of the patient. The presence of arterial scarlet blood in a large volume, which cannot be stopped by conventional means, is a prerequisite for the patient to be urgently taken to the surgical department.

Treatment of the disease

Gastrointestinal bleeding is eliminated in two ways - using conservative means or surgery.

In the event that short time bleeding cannot be eliminated, it is indicated emergency surgery. It is advisable to restore the amount of lost blood before surgery by infusion therapy. In particular, this is an intravenous infusion of blood or drugs that replace it. Such preparation is not carried out when there is a clear threat to the patient's life.

There are two types of surgery, it all depends on the medical indications:

endoscopic method, including laparoscopy, colonoscopy, sigmoidoscopy;
open classical operation.

The essence of the treatment is that the veins of the stomach and esophagus are ligated, the affected area is eliminated and the damaged vessels are coagulated.

Gastrointestinal bleeding syndrome is subject to drug treatment. First of all, hemostatic drugs are administered to the patient. Next, accumulated blood is evacuated from the gastrointestinal tract, which is done through cleansing enemas or using a nasogastric tube. The next step is to restore blood loss and at the same time ensure normal functioning of life. important organs. Next, the disease is diagnosed and treated.

Depending on the consequences of stopping bleeding, the patient is prescribed a diet that helps restore blood, increase its coagulability and improve general state body.

When filling out a medical history, it is currently customary to use special codes. This procedure necessary for convenience and standardization of the diagnosis, as well as for its confidentiality. Therefore, a system has been created that classifies diseases; it is displayed in digital coding. Thus, all kinds of diseases affecting the digestive organs belong to class XI: K00-K93.

Bleeding of the gastrointestinal tract can occur at any age. It is pathological, congenital, infectious nature, is often life-threatening. It is important to provide assistance to the patient at the first symptoms and place him in a medical facility.

Bleeding in the stomach area is an internal outpouring of blood and blood clots into the stomach cavity. The maximum volume of hemorrhage is 4 liters. The causes of bleeding can be a variety of factors: from an incorrectly selected diet to Mallory-Weiss syndrome. Mortality from gastric bleeding is high and amounts to 9% of known cases.

Causes of stomach bleeding

Factors that influence bleeding include:

long-term disruption of the normal psycho-emotional state;
lack of physical activity;
improperly selected diet;
uncontrolled use of medications;
drinking alcohol and tobacco products in large quantities;
infectious and bacterial diseases abdominal organs: duodenal ulcer/stomach ulcer/inflammatory processes in the intestines, intestines, stomach.

Experts use a special classification of causes of bleeding:

Bleeding from an ulcer

Erosion of mucous membranes, their superficial changes.
Formation of a stress ulcer (due to severe trauma, surgery, mechanical damage internal organs).
Drug ulcer. It is formed due to prolonged uncontrolled use of medications (mainly analgesic and anti-inflammatory in nature).
Mallory-Weiss syndrome. Mallory-Weiss syndrome is a superficial rupture of the mucous membrane of the esophagus and one of the gastric sections. Such damage occurs due to incessant vomiting, which is accompanied by hemorrhage. The reason for the formation of Mallory-Weiss syndrome is uncontrolled consumption of alcohol and large amounts of carbohydrate fatty foods.

Intestinal inflammation

Development of rectal hemorrhoids.
Anal fissure.
Formation of tumors in the intestines.
Mechanical injuries of the abdominal cavity.
Infectious diseases (dysentery).

Symptoms and signs

Early symptoms of the disease are as follows:

pronounced weakness of the body appears (the reason for this is an imbalance and blood circulation);
dizziness/blurred consciousness;
the occurrence of shortness of breath, darkening of the eyes;
stuffy ears;
the patient breaks out in a cold sweat;
a sharp drop in blood pressure;
manifestation of tachycardia;
heart rate increases;
loss of consciousness is possible.

One of early symptoms illness - loss of consciousness.

There are also specific symptoms that can vary depending on the cause and type of blood loss:

discharge of vomit with blood particles (can take on a scarlet or dark brown color, scarlet clots indicate the presence of a wound in the esophagus, dark brown clots indicate a wound in the stomach);
the formation of bloody stools, particles of blood that are released along with stool may turn black (with prolonged blood loss);
vomiting mixed with black flakes (a black cotton clot indicates hidden bleeding);
increasing anemia.

Symptoms of the condition depend on the amount of blood lost. Most reliable signs bleeding is vomiting and stool with blood clots. Symptoms also include some specific signs:

the appearance of fear and anxiety (which makes the patient even more vulnerable to illness and disorders of the psycho-emotional state);
pallor of the epithelial covers;
the skin becomes moist and cold;
a sharp jump in heart rate;
increased breathing;
a sharp decrease in blood pressure;
constant feeling of thirst, dry mouth.

Classification

Depending on the location of the bleeding:
1. Upper section (stomach and esophagus area).
2. Lower section (intestinal area).
According to the form of bleeding:
1. Spicy.
2. Chronic.
Based on the bleeding time frame:
1. One-time (manifests in episodes).
2. Recurrent (cyclical manifestation depending on external and other factors).
3. Chronic (permanent).
According to the nature of the bleeding:
1. Hidden.
2. Explicit.

Diagnostics

Primary diagnosis of bleeding is possible only from the words of the victim. The patient independently determines the symptoms, consults a specialist, after which a thorough and quickest diagnosis of his condition follows. If bleeding is suspected, the patient is prescribed bed rest and is prohibited from using food products at the time of diagnosis and determination.

One of the most common and effective diagnostic methods for bleeding is EGDS (esophagogastroduodenoscopy). During endoscopy, a specialist examines the esophagus, stomach, and duodenum using a special medical device. The location of the bleeding, its size and shape are visually highlighted. An additional analysis of the condition of the abdominal organs and the degree of damage to the body is carried out. Before starting EGD, the patient is prohibited from consuming food and liquid. On top part a cold heating pad (or other cold object) is placed in the abdomen, the patient is placed in a lying position and the examination begins.

If, after determining the required data, the doctor is unable to stop the bleeding, they resort to surgery. In some cases, specialists resort to surgery immediately, without initial examination. Such actions are appropriate when there is large blood loss and there is a risk to the patient’s life.

First aid

If there is gastric bleeding, you need to call urgently ambulance

The provision of primary non-skilled actions to maintain the patient’s viability depends on the following factors:

nature of bleeding;
profuse blood loss;
the well-being of the victim (symptoms indicated by the patient);
the possibility of providing qualified medical care.

The primary action is to call an ambulance. Before the ambulance arrives, you should perform several mandatory actions:

help the victim take a lying position;
help prevent food, liquids, and medications from entering the patient’s body;
apply a cold object to the abdominal cavity;
increase the flow of fresh air if you are indoors;
pack your things and Required documents patient for prompt examination and transfer to a medical center.

Therapy and patient care

Treatment of the patient depends on a list of factors (primarily on signs of psychological health and physical indicators). If the patient’s condition is not critical, before starting treatment, a comprehensive diagnosis is carried out, which helps determine the general condition of the patient’s body, subsequent therapy, possible complications and consequences. If there is no time for preparatory actions, the only effective method treatment becomes surgical intervention.

Conservative treatment

Conservative treatment the disease lies in drug therapy.

Conservative treatment consists of drug therapy without resorting to surgical intervention. Treatment consists of following bed rest, which will help reduce blood loss. The victim should be provided with complete emotional and physical rest (muscle contractions can increase blood flow). Abdomen is fixed, a cold object is applied to it, which slows down the outflow of blood and promotes vasoconstriction.

After carrying out the required diagnostic measures (blood in the stomach, food debris, dead tissue must be removed from the organ). The procedure is carried out cold water through the oral or nasal passage using a special tube. After lavage, a probe is inserted into the stomach, through which it is introduced into the body. medicinal substance– adrenaline, norepinephrine. The medication causes muscle contraction, constriction of blood vessels and helps stop bleeding. It is possible to administer intravenously medications that promote rapid blood clotting.

The leakage of blood from vessels that are affected by erosion or pathology is a very dangerous phenomenon. Blood flows to the digestive organs. Considering the severity of the situation and the location of the bleeding source, very disappointing symptoms may appear: fainting, tachycardia, melena, vomiting, the color of which resembles coffee grounds, pale skin and dizziness. Diagnostics will help determine the location of internal hemorrhage: colonoscopy, laparotomy, FGDS, enteroscopy and sigmoidoscopy. There are two main methods to stop bleeding: surgical and conservative. If the patient is not given timely assistance, this can be fatal.

Currently, there are about 100 different pathologies that can cause gastrointestinal tract. If internal bleeding of the gastrointestinal tract occurs, the patient requires emergency professional help.

Hemorrhages are divided into 4 types:

gastrointestinal diseases;
blood pathologies;
portal hypertension;
vascular damage.

Gastrointestinal bleeding can occur with the following diseases: compression of the vein, cirrhosis, chronic hepatitis, constructive pericarditis.

Bleeding from the gastrointestinal tract, manifested due to vascular damage, is treated as such pathological processes, like: red systemic lupus, rheumatism, Ranndu-Osler disease, vitamin C deficiency, periarteritis nodosa, septic endocarditis and scleroderma.

Gastrointestinal bleeding can be a consequence of some blood ailments: chronic and acute leukemia, hemophilia, hemorrhagic diathesis, hypoprothrombinemia.

Situations such as alcohol intoxication, physical stress, chemicals, taking NSAIDs, aspirin and corticosteroids can provoke gastrointestinal bleeding syndrome.

Types of housing and communal services

Before treating hemorrhage, it is important to know the classification of gastrointestinal bleeding. Considering the department digestive system, which serves as a source, distinguish between bleeding from upper sections gastrointestinal tract (duodenal, esophageal, gastric), as well as from lower sections(colon and small intestine, hemorrhoidal).

For gastrointestinal bleeding, the classification takes into account ulcerative and non-ulcerative nature. There are acute and chronic gastrointestinal tract diseases. Depending on its severity, the condition can be hidden or obvious. Regarding the number of episodes, a distinction is made between recurrent and single GIB.

Considering the severity of blood loss, there are 3 degrees of gastrointestinal tract disease. For mild degree typical heart rate is 80, systolic blood pressure is not lower than 110, satisfactory condition and presence of consciousness, dizziness, diuresis is normal. Indicators medium degree acute gastrointestinal bleeding: heart rate - 100 beats per minute, systolic blood pressure - 100-110 millimeters Hg. Art., consciousness and pallor of the skin, cold sweat remain, and diuresis decreases. If such signs occur, it is necessary to call emergency doctors.

Severe gastrointestinal bleeding is manifested as follows: heart rate - more than 100 beats, arterial pressure systolic – less than 100, adynamia and lethargy, anuria or oliguria. The composition of the blood changes significantly.

Clinical picture

Signs of internal bleeding may include:

Gastrointestinal tract infection of the upper sections is accompanied by profuse bloody vomiting, which resembles coffee grounds. This can be explained by the fact that hydrochloric acid comes into contact with the blood. Profuse internal hemorrhage is characterized by scarlet or intense red vomit and tarry stools (melena). In bowel movements there are clots and streaks of scarlet blood, which indicates bleeding from the anal canal, rectum or colon.

The clinical picture occurs against the background of symptoms of the main ailment that provoked dangerous complication. May be observed painful sensations in different parts of the gastrointestinal tract, nausea and belching, intoxication, dysphagia. Hidden gastrointestinal tract infection is especially dangerous, since it can only be revealed by diagnostics.

Complications include the following pathological conditions: acute anemia, hemorrhagic shock, renal and multiple organ failure, and death.

To avoid such complications, competent and timely treatment tactics will be required. It is possible after a complete and in-depth examination of the patient.

Diagnostic methods

Concerning differential diagnosis gastrointestinal bleeding, then she suggests full examination, which begins with determining the medical history, assessing bowel movements and vomit, performing a rectal finger examination. The color of the skin must be taken into account. The abdominal area is carefully palpated to avoid aggravation of the gastrointestinal tract. It is necessary to review the coagulogram, determine the level of urea and creatine, and a kidney test.

X-ray methods will be useful:

irrigoscopy;
celiacography;
x-ray and angiography.

The most effective and accurate method of diagnosis is endoscopy (FGDS, gastroscopy and colonoscopy, as well as esophagoscopy). These tests will help determine the presence of a surface defect on the mucosa, as well as the source of the gastrointestinal tract.

First aid and therapeutic therapy

If dangerous manifestations are detected, it is important to provide the correct assistance in a timely manner. Before the ambulance arrives, you must do the following:

try to place the victim on his back, elevating his legs, and provide him with rest;
It is forbidden to eat or drink, as this stimulates the gastrointestinal tract;
Apply dry ice or a cold object to the suspected source, this will help narrow the blood vessels. It is advisable to do this for twenty minutes with a break of 3 minutes to avoid frostbite;
Give the patient two or three Dicinone tablets (crushed).

It is strictly forbidden to rinse the stomach or give an enema. In case of loss of consciousness, you must use ammonia, monitor your breathing and pulse.

During gastrointestinal bleeding, treatment involves emergency assistance doctors Urgent hospitalization to surgery is indicated, where it will be determined therapeutic tactics. In case of massive blood loss, the patient is given therapy: infusion, blood transfusion, hemostatic.

Vomiting or bloody stools are definitely dangerous symptoms and always indicate possible stomach bleeding. Doctors use the term GI bleeding - gastrointestinal bleeding. This summarizes all cases of blood loss from the digestive system. In the article we will talk about specific symptoms of gastrointestinal tract and their causes.

Danger of bleeding

When an arm or leg is wounded, blood pours out, so it is impossible to miss such bleeding. Internal hemorrhage from the stomach or intestines may remain hidden long time . Its manifestations are not immediately noticeable to a person and even to a doctor.

Therefore, regular examinations, for example, determining the level of hemoglobin in the blood or a stool blood test, are of particular importance.

Blood loss means a decrease in the number of red blood cells - red blood cells - in the blood. Red blood cells contain hemoglobin, a protein that gives them their red color. Hemoglobin plays an important role in the nutrition of the entire body. It carries oxygen to every cell of every human organ. Lack of hemoglobin means shortness of breath.

Hypoxia – lack of oxygen in the body – affects every organ:

For muscles this means severe weakness and inability to work.
For the brain– pain and poor memory.
For heart– pain and rhythm disturbances.

In conditions of blood loss, absolutely all organs suffer, because they all equally do not receive the required amount of oxygen. As bleeding progresses, symptoms become more severe. Depending on the speed of the hemorrhage, the development of a pronounced clinical picture may take several weeks or less than an hour.

All types of blood loss from the digestive system are divided based on the anatomy of the body. This is important in terms of symptoms and causes of hemorrhage.

Doctors differentiate the following types lesions:

Esophageal;
Gastric;
Intestinal.

Causes of bleeding from the esophagus (table and photos)

Causes	What's happening
Mallory-Weiss syndrome	Rupture of the mucous membrane of the esophagus due to repeated vomiting. The reason is frequent vomiting due to poisoning, for example, alcohol. Bleeding occurs directly from longitudinal ruptures of the mucous membrane.
Bleeding from esophageal varices	Cirrhosis of the liver leads to dilation of the veins through which blood flows from the esophagus. Large, superficial veins can rupture without cause. Arises profuse bleeding from pathological, enlarged veins.
Tumor	Tumors are always well penetrated with vessels for nutrition and rapid growth. For malignant tumor– esophageal cancer – typically complicated by bleeding. There is a variant of the tumor - hemangioma, which is completely formed by blood vessels. Such formations bleed profusely and often.
Ulcer	Ulcerative defects in the esophagus can cause small amounts of bleeding if the vessels are not affected. But sometimes the vessel at the bottom of the ulcer is destroyed, ruptured, and large, profuse bleeding occurs.

Symptoms of hemorrhage from the esophagus

The main sign of esophageal bleeding is bloody vomiting. Usually the blood does not have time to be swallowed, so it does not change its color. Based on the severity of bloody vomiting, we can talk about the amount of blood loss. If the bleeding is minor, for example, from an esophageal ulcer, then vomiting does not occur. In this case, only traces of blood can be found in the stool.

Causes of bleeding from the stomach (table and photos)

Causes	What's happening
Peptic ulcer	Under the influence of aggressive factors - stress, high acidity, H. Pylori bacteria - ulcerative defect. A complication is severe bleeding due to arrosive destruction of a vessel near the ulcer. Statistics on gastric bleeding show that this is the most common cause of blood loss.
Ulcers from taking non-steroidal anti-inflammatory drugs	Difference from peptic ulcer in long-term use non-steroidal painkillers - indomethacin, diclofenac. Under their influence, multiple acute ulcers of large size are formed on the surface of the stomach. Usually not called pain syndrome, unlike peptic ulcer disease. Often the first symptom is stomach bleeding.
Tumors and polyps	Tumor formations or polyps on the gastric mucosa can bleed easily, as they are well supplied with blood vessels.
Hemorrhagic gastritis	Inflammation of the gastric mucosa, in which red blood cells leak out of the vessels. Hemorrhages appear in the stomach - hemorrhages on the mucous membrane. Heavy bleeding Gastritis rarely develops; blood is usually found in the stool. The pain is usually severe.

Symptoms of stomach bleeding

The main sign of gastric bleeding is dark vomit. Doctors call this "vomiting" coffee grounds».

Scarlet blood, entering the stomach, mixes with gastric juice. Hydrochloric acid oxidizes hemoglobin, giving the blood a dark, dense brown color. This is the difference between gastric vomiting and esophageal vomiting, which is why this symptom is called pathognomonic. This means it is characteristic only of a specific pathology - gastric bleeding.

If the source of bleeding in the stomach is minor, then vomiting does not occur. Blood particles pass through the entire internal tract. A small amount of blood can only be detected through a stool test.

Causes of bleeding from the intestines (table and photos)

Causes	What's happening
Acute ulcers	Ulcerative defects inside the intestines form less frequently than in the stomach. The duodenum is usually affected, but ulcers of other parts may occur. The mucous membrane ulcerates under the influence of toxic drugs and stress.
Tumors and polyps of the colon	Tumor formations extremely rarely occur in small intestine, usually these are the terminal sections of the intestine. Tumor is common sigmoid colon, rectum or polypous formations in any part of the large intestine. A good vascular supply makes bleeding from the tumor possible at any time.
Nonspecific inflammatory bowel diseases (Crohn's disease, ulcerative colitis)	Autoimmune inflammation in such colitis is associated with an attack of one’s own immunity. The depth of inflammation and prevalence depend on the severity of the disease. Complications of colitis are manifested by bleeding from the affected areas of the intestine.
Infectious colitis, for example, dysentery	Bacterial enterocolitis can cause hemorrhages in the intestines. The most dangerous are Shigella and enterohemorrhagic Escherichia. When an infection develops, red blood cells leak from the vessels and enter the intestinal cavity, causing blood to appear in the stool.
Haemorrhoids	One of the most common reasons appearance of red blood in the stool - bleeding from hemorrhoids. This is an enlargement of the veins of the rectum, associated with many reasons: chronic constipation, flatulence, pregnancy. Such dilated sections of veins have very thin walls, so they can be easily damaged, for example, during defecation.

Symptoms of intestinal hemorrhage

The manifestation of intestinal bleeding is the detection of blood in the stool. Depending on the volume of blood lost and the level of pathology, stool may have a different appearance.

With massive blood loss from the upper intestines, the blood is digested in its cavity. As a result, the stool takes on a deep black color. Doctors call this the term "melena". Typically, stool is quite liquid, which is due to the large volume of blood.

With major bleeding from the large intestine, the blood does not have time to be digested. It mixes with feces. The stool is stained cherry red with blood.

Special symptoms appear if the source of hemorrhage directly in the rectum is a polyp or hemorrhoids. In this case, blood small clots be on top of the feces, without mixing with them. This will indicate hemorrhage from the most terminal parts of the intestine.

Separately, it is worth mentioning hemorrhagic colitis due to dysentery. Only it is characterized by symptoms that are not similar to other bleeding. Due to the large amount of mucus in the stool and the entry of red blood cells into the intestinal lumen, the stool takes on the appearance of “raspberry jelly.”

Minor bleeding from the large or small intestine cannot be visually noticed. In this case, the tactics are the same as for minor blood loss from the esophagus or stomach. Traces of blood are found in laboratory analysis feces

Common symptoms of gastrointestinal bleeding

In addition to specific signs of blood loss, specific to each part of the gastrointestinal tract, there are other criteria for bleeding. This general symptoms, characteristic of blood loss and anemia. Their cause is hypoxia and lack of blood volume.

Signs that are absolutely the same for any type of hemorrhage:

Weakness;
Dizziness;
Flashing before the eyes of “flies” and “black dots”;
Loss of consciousness;
Rapid pulse and low blood pressure;
Pale skin;
Cold sweat;
Thirst and dry mouth;
Decreased urine output.

Diagnostics

Diagnostic methods for suspected gastrointestinal bleeding are divided into:

Laboratory;
Instrumental.

Laboratory methods are necessary if the question arises of how to determine the degree of blood loss and tactics for replenishing blood volume. They are universal for any hemorrhage. Instrumental methods vary depending on the clinic. For some pathologies instrumental methods diagnostics become therapeutic, since with their help it is possible to eliminate the source of bleeding.

Research method	When to use	What can show
General blood analysis	For any hemorrhage	decrease in red blood cells;
		decrease in hemoglobin;
		decrease in color index
Blood chemistry	For any hemorrhage	decreased clotting rates;
		increased bleeding rates;
		liver failure
Fecal occult blood test	If occult bleeding is suspected	Does not differentiate the source of bleeding, only confirms the fact of its presence
Fibrogastroduodenoscopy	If esophageal or gastric bleeding is suspected	The source of hemorrhage is visually detected in the wall of the esophagus or stomach.
Sigmoidoscopy	If you suspect bleeding from the rectum	Detection of polyp, rectal tumor, inflammatory changes
Colonoscopy	If you suspect intestinal bleeding	Detection of polyp, colon tumor, inflammatory changes in the mucosa

First aid and treatment

Bleeding from the gastrointestinal tract can be severe. Losing more than 30% of the body's total blood can be fatal.

Therefore, if you suspect hemorrhage, you should try to provide the maximum possible assistance:

Apply an ice pack to your stomach;
Do not give food or medicine;
Take to the emergency department as soon as possible.

Inpatient treatment is carried out in surgical department or in the ward intensive care if bleeding has reached critical levels.

The source of hemorrhage can be eliminated:

Conservatively– rinsing with ice water and drugs that improve clotting;
Endoscopically– cauterization or suturing during fibrogastroduodenoscopy;
Open intervention– if it was not possible to stop the bleeding using the previous two methods.

For hemorrhages associated with nonspecific inflammatory diseases intestines, strong anti-inflammatory therapy is used. The drugs reduce the aggressiveness of one’s own immunity, reducing the activity of inflammation.

Medicines can be used separately or in combination:

Anti-inflammatory– sulfasalazine;
Cytostatics– methotrexate;
Glucocorticosteroids– prednisolone;
Monoclonal antibody preparations– infliximab.

Hemorrhoidal bleeding can be treated conservatively with the help of drugs that improve coagulation. But with constantly recurring episodes, a planned operation is performed. It consists of eliminating hemorrhoids.

Small interventions are also possible:

Sclerotherapy;
Applying latex rings.
Regardless of the source of bleeding, the victim will require infusion therapy:
Saline solutions - Ringer's, physiological solution;
Colloids – Gelofundin, Venofundin;
Erythrocyte mass.

The indication for red blood cell transfusion is rapid decline hemoglobin below 70 g/l. In this case, it will be impossible to restore lost hemoglobin without transfusion. Therefore, red blood cell preparations that match the antigens with a person’s own blood group are used.