Massive GI Hemorrhage Treatment

About Massive GI Hemorrhage

Massive GI hemorrhage refers to gastro intestinal bleeding. Massive GI hemorrhage poses a huge risk to a patient's life. It can lead to heavy organ damage as well as internal toxic poisoning or infections. In some cases, massive GI hemorrhage needs to be treated as a medical emergency.

Causes of massive GI hemorrhage: Gastro intestinal tract is the path created from the mouth to the rectal organs primarily including the stomach and the intestines. It forms a prominent part of the digestive and immune system. It is also responsible for major body functions such as, generation of hormones and throwing out waste. The gastro intestinal tract is subject to wear and tear and aging as well as numerous diseases. It is prone to ulceration or cirrhosis which damages the walls of the GI tract. This may lead to bleeding from the gastrointestinal tract. Massive GI hemorrhage can occur in the upper and lower gastrointestinal tract.

Following risk factors have being identified, for massive GI hemorrhage of the upper tract:

• Esophageal varices, cancers, ulcers and diseases like Mallory -Weiss tear
• Gastric ulceration, cancer, varices, antral vascular ectasia, Dieulafoy's lesions, etc
• Duodenal ulceration, vascular malformations such as aorto-enteric fistulae, Hematobilia or biliary tree bleeding and Hemosuccus pancreaticus

Other causes may be over intake of NSAIDS (Non-steroidal anti-inflammatory drugs) and other medications, alcoholism, chronic infections and ulceration of the liver such as those by Helicobacter pylori.

Following risk factors have being identified, for massive GI hemorrhage of the lower tract:

• Coagulopathy, Hemorrhoids, Colitis, ulceration
• Infections like, Salmonella, Campylobacter jejuni
• Angiodysplasia, cancer, diverticulosis and diverticulitis, colonic polyps, etc.

Other causes include chronic constipation, bowel movement disorders, low fiber diet, pregnancy issues, anal fissures, Crohn's disease, rectal foreign bodies, diarrhea, and colon cancer.

Symptoms of massive GI hemorrhage: Symptoms of massive GI hemorrhage are as follows:

• Sudden bleeding during bowel movement
• Blood stained stools, dark, black or tarry stools, urinary incontinence or red tinged urine
• Pain during bowel movement, extreme pain in the abdominal region
• Vomiting, nausea, dizziness, loss of consciousness, coma in extreme cases

Diagnosis of massive GI hemorrhage: Massive GI hemorrhage needs urgent medical care. A patient is usually taken to emergency medical care facility where he is diagnosed quickly. Following signs are observed and immediate diagnostic tests are taken as follows:

• Orthostatic signs such as observations of the patient while standing sitting or sleeping,
• Bleeding, vital signs such as breathing, nausea, vomiting are observed
• Hematocrit, Hemoglobin, and platelets count is taken using blood or urine tests
• Nasogastric aspiration may be used to observe bleeding and location of the bleeding
• Differential diagnosis may be done for diverticulosis, colitis or other diseases
• Blood urea, nitrogen level, pulse, blood pressure, too may be observed

In certain case, bedside emergency ultrasound machine may be used to monitor the patient's condition. CT scan, MRI or Doppler ultrasound may be used to provide live images. Often endoscopic examination of the gastric tract is advisable.

Treatment of massive GI hemorrhage: In emergency cases, intravenous solutions and blood is administered to replace the lost blood. Other treatments include as follows:

• Medications such as proton pump inhibitor are used to reduce gastric juice secretion
• Terlipressin, Octreotide etc. are used to control blood flow
• Antibiotics may be used to reduce the risk of infections, sclerotherapy drugs to treat blood vessels
• In some cases, surgery must be carried out; surgery is used to sew the bleeding points.
• Electrocautery or endoscopic clipping is done to reduce bleeding and close the bleeding points
• Tranexamic acid may be prescribed during surgery which prevents excessive blood loss

Some other treatment options are as follows:

• Factor VII administration which helps coagulation
• Balloon tamponade is used to stop excessive bleeding
• In case of fecal blockages, these may be removed endoscopically
• Other medications such as coagulants and blood plasma controllers

Treatment may be critical in many cases and lasts from few hours to even few days. Extensive post surgical management may be required which helps the patients recuperate. A special diet may be followed to support body functions. A life support or dialysis machine may be required along with breathing machine in some critical patients.

Thus, massive GI hemorrhage requires emergency medical care and attention. If you observe symptoms of massive GI hemorrhage, do contact your nearest hospital immediately. Do feel free to ask medical questions about massive GI hemorrhage to your doctor so that it can be treated on time.