Intestinal bleeding: the release of blood in the lumen of the colon or small intestine, a symptom that requires early medical intervention. It can be caused by a pathological process in the intestines and organs associated with it, or by injury.
If time does not take measures to stop, it can pose a serious danger to the patient’s life.
Bleeding from the duodenum is the most common after the gastric. It represents 30% of all cases of gastrointestinal (gastric – more than 50%) hemorrhage.
10% of the sources of lesions are located in the large intestine and 1% in the small intestine.
The profuse gastric bleeding is not easy to distinguish with the intestinal due to the similarity of its signs, the adjacent location of the organs and belonging to a single system. The international classification of diseases of the tenth revision (ICD-10) of bleeding from the stomach and intestines are combined in a K92 group.
Types of intestinal bleeding
By location of blood loss:
- It arose in the upper intestine (duodenal ulcer)
- Emerged in the lower intestine (small, large, straight).
As a manifestation:
- Have clear signs of presence.
- Hidden, imperceptible to the victim.
Types of gastrointestinal bleeding
By the nature of the flow:
- In acute form
- In a chronic way
For the duration:
A wide range of pathologies can be accompanied by loss of blood in the intestines.
Causes of gastrointestinal bleeding
Usually they are divided into 4 groups:
- Diseases of ulcerative and non-ulcer character. Ulcerative lesions are the most common cause of intestinal bleeding (about 75% of all cases, and separately for men, the indicator is higher).
- Duodenal ulcer, Emerged after gastrectomy and other surgical interventions in the gastrointestinal tract.
- Ulcerative colitis
- Multiple ulcers of the large intestine., accompanying Crohn’s disease
- Bleeding ulcers, resulting from burns to the mucous membranes (due to poisoning with concentrated acid, mercury, lead, etc., prolonged use of medications)
- Ulcers in the field of mechanical trauma of the digestive tract.
- Formed in the context of stress or physical stress.
Non-ulcer intestinal bleeding:
- Diverticuli (bag-shaped growths in the intestinal wall)
- Bacterial colitis
- Hemorrhoidal protuberances, result of abnormal varicose veins
- Fissures of the anal fissure
- Malignant (sarcoma, cancer) and benign tumor formations (polyps, lipoma, etc.) of different localization.
- Parasitic diseases
- The infections
- Diseases that cause an increase in blood pressure in the portal vein of the liver (portal hypertension):
- Thrombosis of the portal vein and other hepatic veins.
- Compression of the portal vein by a tumor or scar tissue.
- Vascular diseases:
- Inflammation of the walls.
- Aneurysms (thinning of the walls)
- Thrombosis and embolism (closing of light)
- Angiodysplasia (increase in the number and size of intestinal vessels)
- Lupus erythematosus
- Congenital anomalies
- Blood pathologies:
- Coagulation problems As a result of platelet deficiency or genetically determined
- Violations that are included in the hemorrhagic diathesis group, which present: spontaneous, spontaneous hemorrhages or caused by minor injuries (trombotions, etc.)
Intestinal hemorrhage in children.
Intra-intestinal effusion in babies can cause intestinal volvulus, intestinal obstruction.
The disease is expressed not so much by excretion of blood, as by constipation, gas, acute pain in animals.
Another factor is intestinal congenital anomalies and neoplasms.
In older children, the main culprits of intestinal bleeding are polyps. A common cause of hemorrhage in young children: foreign objects in the digestive tract, which damage the mucous membrane.
When internal gut bleeding is strong enough, it is easy to diagnose. It is determined by the presence of blood in the stool and vomiting.
If the blood is present in the stool without changes, this indicates its loss of more than 100 ml once. This may be a profuse gastric flow, or the loss of blood from the duodenal ulcer as a result of an extensive ulcer. If the blood runs for a long time, under the influence of enzymes it secretes iron and paints the stool in a tarred black color.
With a small discharge, changes in stool are not visually visible.
They are not always dark colored stools – a sign of intestinal bleeding. Sometimes this is a consequence of eating a meal rich in iron or certain drugs.
And sometimes, the result of swallowing blood to patients (this can happen, even if the nasopharynx or oral cavity is damaged).
When blood clots are visible on the surface of the stool, it can be concluded that there are diseases in the lower part of the large intestine. In the event that the blood is mixed with the feces, forming striae, the lesion is located in the upper sections.
The liquid stools, stinking, with a characteristic brightness, most likely, say about the defeat of the small intestine.
Another characteristic symptom is profuse vomiting. In the context of intestinal bleeding, profuse vomiting is an abundant rash of the contents of the gastrointestinal tract with impurities from the blood.
Sometimes, due to the reaction of the blood with the sour gastric juice, the vomit becomes saturated brown.
Other symptoms of intestinal bleeding
- Anemia It occurs as a result of prolonged blood loss, when the body can not compensate for the loss of red blood cells. Anemia, without resorting to medical examinations, may be late to a state of weakness, drowsiness, dizziness, fainting, excessive pallor, cyanosis, hair and brittle nails, tachycardia
- A variety of disorders of the digestive process: nausea, vomiting, diarrhea or constipation, excessive gas, bloating
- Part of the victims of intestinal bleeding experience anxiety, fear, alternating with inhibition or euphoria.
- Intestinal pain Depending on the disease that caused the intestinal bleeding, the nature of the pain syndrome may be different. Therefore, a duodenal ulcer is accompanied by a sharp and sharp pain in the abdomen and decreases when bleeding is opened. In patients with cancer, the pain is annoying, dull and appears sporadically. In ulcerative colitis, it migrates, and in the case of dysentery, it accompanies the need to defecate.
Portal hypertension, in addition to intestinal bleeding, manifests typical symptoms of it:
- Loss of weight of the patient.
- The appearance of spider veins.
- Strong reddening of the palms (erythema).
The history of these patients is often detected by experienced hepatitis or prolonged alcohol intake.
The blood clotting problems associated with cirrhosis cause massive and persistent intestinal bleeding.
Non-specific ulcerative colitis is accompanied by false impulses to the toilet, and the feces themselves are fluid, purulent, viscous and impurities of the blood. In diseases of the inflammatory nature of intestinal bleeding is observed in the context of high temperature.
In the case of intestinal cancer, small blood secretions are typical, tarry stools, along with the typical symptoms of this disease: drastic weight loss, loss of appetite.
It should be remembered that sometimes the bleeding does not manifest itself and is found by chance during a medical examination to detect other diseases, including those not related to the gastrointestinal tract.
The status of victims of open intestinal bleeding.
- Satisfactory a person is conscious, at a normal level his blood pressure, hemoglobin and red blood cell count, but his pulse increases
- Moderate The coagulability worsens, the hemoglobin decreases sharply (to half of normal), the pressure decreases, tachycardia appears, cold sweat. Pale skin
- Heavy the face swells, the hemoglobin is very low (up to 25% of normal), the pressure is reduced considerably, the pulse increases. There is a slowdown in movement and speech. This condition often leads to coma and requires urgent resuscitation.
How to stop at home
If the intestines are bleeding, the first medical help is in measures aimed at reducing blood loss:
- The patient must make sure to rest: Lay him on his back and lift his legs slightly:
- In no case do not stimulate the digestive tract. Drinking and feeding for intestinal bleeding should be excluded.
- The maximum narrow vessels: put in a possible ice kettle or something cold.
First aid in the home should not include enemas and gastric lavage.
Diagnosis of intestinal bleeding
The examination of patients with hemorrhage is performed by a gastroenterologist and endoscopist. The condition of the skin is evaluated, the abdomen is palpated..
A digital rectal examination is carried out, whose purpose is to identify hemorrhoidal polyps and cones, as well as to evaluate the condition of the organs located near the intestines.
To determine severity, the patient’s blood is examined urgently (clinical analysis and coagulogram), determining the amount of hemoglobin and red blood cells and the ability of the blood to clot.
Stool fecal occult blood. The anamnesis is collected from the patient, the pressure and pulsation are checked.
To determine the source of intestinal bleeding, apply instrumental techniques:
- Endoscopy (in most cases, it determines the source and allows simultaneous treatment (electrocoagulation of the diseased vessel or another) and
- Colonoscopy (study of the upper sections).
- Additional information is obtained by X-ray examination and scintigraphy with marked red blood cells.
The results of instrumental diagnoses are crucial in the question of what to do with gastric or intestinal bleeding.
The victims of intestinal hemorrhage with signs of hemorrhagic shock (low blood pressure, tachycardia, cold extremities, cyanosis) need emergency hospitalization. An endoscopy is performed urgently, the source of blood loss is corrected and measures are taken to stop the bleeding.
What endoscopy shows
The indicators of blood movement and its cellular composition are constantly evaluated.. The patient is given blood products.
But most often, the treatment is of a conservative nature and is aimed at the elimination of the source of intestinal bleeding, the revitalization of the hemostatic system and the replacement of blood at normal volume.
Medications prescribed to stop the blood.
To reduce the pressure in the portal vein, platelet activity is stimulated with medication.. Given the scale of blood loss, plasma substitutes and blood donors are injected.
The loss of blood leads to a change in the structure of the affected tissues, and it takes time to heal them. The first 2-3 days of nutrients for the victim are administered intravenously and are gradually transferred to a standard diet with a strict diet.
The lesions heal for at least six months, and during all this time the patient’s diet must be given maximum attention. After 6 months, the patient is reexamined by a gastroenterologist.
Video: Help with gastrointestinal bleeding.
Diet is one of the main conditions for the recovery of patients with intestinal bleeding.
In order not to injure the intestinal wall, they are prescribed:
- Soups Of Mucus
- Liquid porridge
- Puree (meat, fish, vegetables)
- Kissels and gelatin
- The milk
- Weak tea
- Vegetable juices
- Spicy food
- Everything that causes irritation of the mucous membranes.
More than 90% of cases of intestinal bleeding can be stopped with conservative methods.
If signs of internal blood flow persist, resort to surgery, the amount of which depends on the nature of the pathology.
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