Thepatient may be diagnosed with ulcers or esophageal varices because ofthe upper GI bleeding due to the presence of coffee like blood invomit. These are characterized with lower GI bleeding presented bydark stool, polyps of the large intestine, or hemorrhoids. There maybe bleeding in the small intestine which may be due abnormalities inblood vessels, tumors or Meckel diverticulum. Age is an additionalfactor in this diagnosis since the conditions are more common inolder people.
Diagnostictests that can be done include blood tests hematocrit, stool smear,CT scan, upper endoscopy, colonoscopy, and angiography. Stool smearsare to confirm the presence of blood in the stool. CT scans will helpassure deformation of the small intestine or diverticulum. A hollowplastic tube called nasogastric tube can be used to get from thestomach contents. It can reveal active bleeding. Upper endoscopy isthe visual examination of the parts of the upper GI. The bleedingsource can be identified. Colonoscopy enables examination of thelower GI. Angiography will help the doctor diagnose the bleeding andcome up with effective management strategies.
Thegoal of treatment is to replace lost blood and stop the bleeding.Possible treatment options are IV fluid replacement blood transfusionand injection with vitamin k. Bleeding can be stopped by endoscopyusing electrocautery device or injection sclerotherapy. Electrocautery device has an electoral current to produce heat.Angiography can be employed it involves the passing of a catheterinto the bleeding site and injection of chemicals or wire to blockthe broken vessel (Alldredge et al. 2013). Vasopressin can also beinjected to reduce blood flow to the site. Endoscopy is the firstchoice to stop bleeding. Colonoscopy using an electrocautery devicecan be useful when stopping bleeding due to the diverticulum. Severebleeding can only be stopped through anoscopy or surgery.
Alldredge,B. K., l Corelli, R., Ernst, M. E., Guglielmo, B. J., Jacobson, P.A., Koda-Kimble, M. A.,& Young, L. Y. (Eds.). (2013). Appliedtherapeutics: the clinical use of drugs.Wolters Kluwer/Lippincott William & Wilkins