💌 🌘 👩🏾‍🌾 Gastric bleeding: symptoms, diagnosis, emergency care 🙇🏼 🐰 🈺

Gastric bleeding is an extremely dangerous condition, which in the absence of timely help can lead to complications such as shock and multiple organ failure. The causes of blood loss can be very different. That is why many people are interested in additional information about this pathology.

What are the symptoms of blood loss? What are the causes of the appearance of pathology? What does emergency care for stomach bleeding look like ? What treatment methods does modern medicine offer? Answers to these questions will be useful to many readers.

Bleeding from stomach ailments

In fact, there are many diseases of the digestive system that can lead to bleeding.

First of all, it is worth talking about peptic ulcer, since in 15-20% of patients this pathology is complicated by bleeding. Against the background of this disease, thrombosis of the vessel is possible (its wall bursts due to a sharp increase in pressure) or its damage under the influence of gastric juice.
The list of reasons should also include the presence of malignant tumors in the stomach. The constant growth of the neoplasm can lead to vascular damage. In addition, bleeding may be due to trauma to the tumor itself.
A risk factor is the presence of a diverticulum - a kind of protrusion of the wall of the stomach. Inflammation or trauma of this structure is often accompanied by vascular damage and blood loss.
With diaphragmatic hernia, the cardiac part or the bottom of the stomach can move into the chest cavity. As a result of such a pathology, gastric juice begins to be thrown into the esophagus. Damage to the mucous membrane of this organ is sometimes accompanied by bleeding.
A polyp of the stomach can lead to the same result. Despite the fact that this is a benign formation, its trauma or ulceration of the walls under the influence of gastric juice is accompanied by a loss of blood. In addition, the polyp can twist around its legs or infringe, which also leads to damage to small vessels.
The cause may be hemorrhagic gastritis. This form of the disease is accompanied by inflammation of the gastric mucosa and the formation of erosive patches on it.
There is a so-called “stress” ulcer. As you know, nervous strain and strong emotions affect all organ systems. Amid stress, the adrenal glands synthesize a huge amount of glucocorticosteroids, which leads to increased production of gastric juice. Under the influence of hydrochloric acid, the walls of the stomach can ulcerate, which is accompanied by damage to blood vessels and the appearance of bleeding.

It is worth noting that each of these diseases has its own unique clinical picture. The presence of nausea, heartburn, pain in the epigastric region - these are all important symptoms that you should definitely inform your doctor about.

Vascular disease

Gastric bleeding is not always directly related to diseases of the digestive organs. Blood loss may be due to vascular damage.

Risk factors include varicose veins of the upper part of the stomach and esophagus. With such a pathology, the walls of the vessels become very weak, which increases the risk of damage and, consequently, the occurrence of bleeding. In turn, varicose veins can be the result of tumors and cirrhosis of the liver, thrombosis or compression of the portal vein, chronic lymphocytic leukemia.
Systemic vasculitis can also cause hemorrhage. This is an autoimmune disease that is accompanied by damage to the vascular walls as a result of exposure to specific antibodies produced by the immune system. Veins and arteries become weak, which increases the risk of rupture.
Atherosclerosis is a pathology that is characterized by the formation of atherosclerotic plaques on the walls of blood vessels. As a result of this process, the lumen of the vessel decreases. Any injury or a sharp jump in blood pressure can lead to damage to the artery wall.

Clotting problems

In some cases, gastric bleeding is associated with a violation of blood coagulation processes. The list of risk factors is quite large.

Hemophilia is a hereditary pathology, which is accompanied by a violation of blood coagulation. Blood clots do not form, so stopping the bleeding is very difficult.
Leukemia (acute and chronic forms) - cancer of the blood, in which the process of hematopoiesis in the bone marrow is disrupted, in particular, there are problems with the formation of platelets.
Hemorrhagic diathesis is also accompanied by increased bleeding and clotting problems.
Vitamin K plays an important role in the formation of blood clots in vascular damage. With its deficiency, hemorrhages in the internal organs, increased bleeding are observed.
Hypoprothrombinemia is a pathology accompanied by a deficiency of prothrombin in the blood.

Gastric bleeding: symptoms

The sooner a person is provided with qualified help, the lower the likelihood of complications incompatible with life. So what does the clinical picture look like with gastric bleeding? Symptoms are very diverse.

First, common signs of blood loss appear. A person becomes lethargic, complains of dizziness, tinnitus. The patient’s pulse is weak, blood pressure gradually decreases. The patient's skin turns pale, often cold sweat comes out. Inhibition, confusion is observed. It is difficult for the patient to concentrate, it is difficult to answer questions. Possible loss of consciousness.
Of course, there are other features that characterize gastric bleeding. A sign of pathology, and it is very characteristic - vomiting with blood. Most often, vomitus consistency resembles coffee grounds, because blood, getting into the stomach, gives in to hydrochloric acid. If vomiting contains scarlet unchanged blood, this may indicate massive arterial bleeding from the stomach (blood loss is so fast and massive that the blood does not have time to react with acidic gastric juice).
Traces of blood are also present in fecal matter. Feces become black and have a tarry texture. If veins of scarlet unchanged blood are visible in the discharge, then this indicates the presence of intestinal, not gastric bleeding.

If a person has such symptoms, then he must be taken to a hospital immediately. First aid for stomach bleeding is very important. Lack of timely therapy may result in the death of the patient.

Complications

Internal gastric bleeding is an extremely dangerous condition that can trigger the development of complications.

Excessive blood loss often leads to hemorrhagic shock.
High risk of acute anemia. In the blood, the number of red blood cells decreases sharply, as a result of which the cells and tissues do not receive enough oxygen (it is the red blood cells that ensure its transportation).
Against the background of gastric bleeding, an acute form of renal failure often develops.
There is a risk of multiple organ failure. This is a reaction of the body to stress caused by blood loss, resulting in a malfunction of several organ systems.

It is worth noting that untimely assistance with gastric bleeding, as well as attempts to cope with the problem on their own, may result in the death of the patient.

Diagnostic measures

A patient with symptoms of blood loss must be taken to the hospital. Diagnosis of gastric bleeding includes a number of procedures.

As a result of a general blood test, you can notice that the number of red blood cells and platelets is much lower than normal - this indicates a possible internal bleeding.
A coagulogram is performed if there is a suspicion of a violation of normal blood coagulation.
Fibrogastroduodenoscopy is a procedure during which a doctor examines the mucous membrane of the esophagus, stomach and upper intestines using a special probe. This technique sometimes allows you to accurately determine the place of bleeding and to evaluate its scale.
Radiography of the stomach is performed in order to determine the possible cause of bleeding. For example, in the picture, the doctor can see ulcerative lesions, diaphragmatic hernia, existing tumors, etc.
Angiography is a procedure that allows you to evaluate the blood flow in a particular vessel. Using a special catheter, a contrast agent is injected into the vessel, after which a series of x-rays are taken. On them, a stained vessel is ideally visible, while blood flow can be monitored.
Scanning using isotopes involves the introduction of labeled red blood cells into the patient's body. Red bodies accumulate at the site of bleeding - it can be visualized in pictures.
Magnetic resonance imaging allows the doctor to obtain three-dimensional images of organs, assess the degree of damage, detect the site of bleeding, etc. This procedure is required if the patient is shown surgery.

First aid for gastric bleeding

Having noticed the above symptoms in a person, an urgent need to call a team of doctors. First aid for gastrointestinal bleeding is extremely important. Its algorithm is as follows.

The patient needs to be laid, you can substitute a small pillow under his feet.
The patient should not move, it is recommended to stay alone.
With bleeding, you can not eat and drink, as this stimulates the stomach, which causes increased blood loss.
Something cold should be put on the stomach, for example, pieces of ice wrapped in a towel. Cold constricts blood vessels, thereby stopping bleeding.

Conservative therapy

All other measures aimed at stopping the bleeding of the gastrointestinal tract are carried out already in a hospital.

As a rule, first the stomach is washed with ice water - this helps to narrow the vessels. A special tube probe is inserted directly into the stomach through the oral or nasal cavity.
In the same way, adrenaline and norepinephrine are delivered to the stomach. These substances are stress hormones that cause spasm of blood vessels and make it possible to stop blood loss.
Medications are administered intravenously to patients that increase blood coagulation. As a result of such therapy, blood clots form in the damaged areas of blood vessels, which helps stop or slow down blood loss.
If gastric bleeding has led to the loss of a large volume of blood, a transfusion is indicated to the patient (donor blood, frozen plasma, blood substitutes can be used).

Endoscopic treatments

If the bleeding is slight, it can be stopped using endoscopic procedures. These include the already described chipping of damaged areas with adrenaline and norepinephrine. In addition, other techniques may be used.

Electrocoagulation is a procedure in which a special endoscope is inserted into the stomach and burns the damaged walls of the organ and blood vessels through electric current.
Laser coagulation - tissue is cauterized using a laser beam.
Sometimes applications from a special medical glue are applied to the walls of the stomach.
It is also possible endoscopic application of metal clips and stitching of damaged vessels with threads.

When is surgery necessary?

Unfortunately, in some cases, gastric bleeding can be stopped only during a full surgical intervention. The operation is shown in the following cases:

massive bleeding and rapid decrease in blood pressure;
Attempts to stop the loss of blood with medication were unsuccessful;
the patient has systemic disorders (for example, coronary heart disease, problems with cerebral circulation);
after successful drug or endoscopic treatment, bleeding started again.

Surgery on the stomach can be carried out both through an incision in the abdominal wall, and through laparoscopic equipment (only small punctures are made in the abdominal region). There are many procedures designed to eliminate bleeding:

stitching of the damaged area of the organ;
removal of the stomach or any part thereof (it all depends on the cause of the bleeding);
endovascular procedures, in which the probe is inserted through the femoral artery, reaches the bleeding vessel and closes its lumen.

Only the attending physician can determine the appropriate technique, since everything depends on the general condition of the patient, the degree of blood loss, the cause of bleeding, the presence of concomitant pathologies, etc.

Gastric bleeding: symptoms, diagnosis, emergency care