User:Mr. Ibrahem/Upper gastrointestinal bleeding
| Upper gastrointestinal bleeding | |
|---|---|
| Other names | Upper gastrointestinal hemorrhage, gastrorrhagia, upper GI bleed, UGI bleed |
 | |
| Endoscopic image of a posterior wall duodenal ulcer with a clean base, a common cause of upper gastrointestinal bleeding. | |
| Specialty | Gastroenterology |
| Symptoms | Vomiting blood, black stool, abdominal pain, lightheadedness[1] |
| Complications | Shock, anemia[2] |
| Causes | Peptic ulcers, gastritis, varices, gastric cancer, Mallory-Weiss tears, vascular malformations[1][3] |
| Risk factors | Blood thinners, aspirin, NSAIDs, Helicobacter pylori, kidney failure, liver disease, prior bleeding[1][3] |
| Treatment | Fluid replacement, blood transfusion, endoscopy[3] |
| Medication | Proton pump inhibitor, octreotide[3] |
| Frequency | ~1 per 1,000 per year[1][3] |
Upper gastrointestinal bleeding is bleeding from the esophagus, stomach, or duodenum.[1] Symptoms may include vomiting blood, black stool, abdominal pain, and lightheadedness.[1] Complications may include shock and anemia.[2]
Causes include peptic ulcers, gastritis, varices, gastric cancer, Mallory-Weiss tears, and vascular malformations.[1][3] Risk factors include blood thinners, aspirin, NSAIDs, Helicobacter pylori, kidney failure, liver disease, and prior bleeding.[1][3] Diagnosis is often supported by a complete blood cell count (CBC), BUN, and endoscopy.[3]
Intravenous fluid replacement, including blood transfusion, may be required.[3] Proton pump inhibitors are generally given.[4] Endoscopy is recommended within 24 hours in those who are unstable, during which bleeding can be stopped by various techniques.[1][5] In those with varices, octreotide may be used.[3] Tranexamic acid has not be found to be useful.[6] Other options may include embolization or surgery.[1] In about 15% of people bleeding reoccurs.[3]
Upper gastrointestinal bleeding affects around 5 to 15 people per 10,000 a year.[1][3] It occurs more commonly in older people.[1] It represents over 50% of cases of gastrointestinal bleeding.[4] The risk of death is between 2 and 10%.[7]
References[edit]
- ^ a b c d e f g h i j k l Wilkins, T; Wheeler, B; Carpenter, M (1 March 2020). "Upper Gastrointestinal Bleeding in Adults: Evaluation and Management". American family physician. 101 (5): 294–300. PMID 32109037.
- ^ a b "Gastrointestinal bleeding - Symptoms and causes". Mayo Clinic. Archived from the original on 2 March 2021. Retrieved 9 March 2021.
- ^ a b c d e f g h i j k l Antunes, C; Copelin II, EL (January 2021). "Upper Gastrointestinal Bleeding". PMID 29262121.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b Beyda, R; Johari, D (22 July 2019). "Tranexamic acid for upper gastrointestinal bleeding". Academic Emergency Medicine. 26 (10): 1181–1182. doi:10.1111/acem.13835. PMID 31329328.
- ^ Barkun, AN; Almadi, M; Kuipers, EJ; Laine, L; Sung, J; Tse, F; Leontiadis, GI; Abraham, NS; Calvet, X; Chan, FKL; Douketis, J; Enns, R; Gralnek, IM; Jairath, V; Jensen, D; Lau, J; Lip, GYH; Loffroy, R; Maluf-Filho, F; Meltzer, AC; Reddy, N; Saltzman, JR; Marshall, JK; Bardou, M (22 October 2019). "Management of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group". Annals of Internal Medicine. 171 (11): 805–822. doi:10.7326/M19-1795. PMC 7233308. PMID 31634917.
- ^ Kamal, F; Khan, MA; Lee-Smith, W; Sharma, S; Imam, Z; Jowhar, D; Petryna, E; Marella, HK; Aksionav, P; Iqbal, U; Tombazzi, C; Howden, CW (December 2020). "Efficacy and safety of tranexamic acid in acute upper gastrointestinal bleeding: meta-analysis of randomised controlled trials". Scandinavian journal of gastroenterology. 55 (12): 1390–1397. doi:10.1080/00365521.2020.1839963. PMID 33112175.
- ^ Stanley, Adrian J; Laine, Loren (25 March 2019). "Management of acute upper gastrointestinal bleeding". BMJ: l536. doi:10.1136/bmj.l536.