Chronic gastritis black stool

Chronic gastritis is a gastric mucosal disease, and its causative factors are closely related to bad eating habits, viral infection, drug stimulation, etc. Some patients with chronic gastritis also have black stools. Black stools caused by chronic gastritis is not just a condition. It is very likely that you are also suffering from gastrointestinal bleeding. You can learn about this disease and make a comprehensive judgment based on your own condition. Let’s take a look below.

Black stools are also called tarry stools, and the stools are black or brownish black. It is one of the most common symptoms of upper gastrointestinal bleeding. If the amount of bleeding is small and the bleeding rate is slow, the blood stays in the intestine for a longer time and the feces discharged is black; if the amount of bleeding is large and the bleeding time in the intestine is shorter, the discharged blood is dark red; if the amount of bleeding is particularly large and is discharged quickly, it may also be bright red.

Clinical manifestations of gastrointestinal bleeding

The clinical manifestations vary depending on the site, amount and rate of bleeding.

1. General Condition

Small amounts (less than 400 ml) and chronic bleeding often have no obvious symptoms. In case of acute and massive bleeding, symptoms such as dizziness, palpitations, cold sweats, fatigue, dry mouth, and even fainting, cold limbs, oliguria, irritability, and shock may occur.

2. Vital signs

Changes in pulse and blood pressure are important indicators of the extent of blood loss. In acute gastrointestinal bleeding, blood volume decreases sharply, and the initial compensatory function of the body is to increase the heart rate. If the bleeding cannot be stopped or blood volume cannot be replenished in time, a shock state will occur and the pulse will be weak or even unclear. In the early stages of shock, blood pressure may increase compensatorily. As the amount of bleeding increases, blood pressure gradually decreases, and the patient enters a state of hemorrhagic shock.

3Other associated symptoms and signs

Depending on the primary disease, there may be other corresponding clinical manifestations, such as abdominal pain, fever, intestinal obstruction, hematemesis, bloody stools, tarry stools, abdominal masses, spider nevi, varicose veins of the abdominal wall, jaundice, etc.

treat

Treatment principles vary depending on the primary disease, amount of bleeding and rate of bleeding.

1. Upper gastrointestinal bleeding

2. Middle and lower gastrointestinal bleeding

(1) Symptomatic treatment of chronic, small-volume bleeding mainly targets the primary disease (cause). In case of acute massive bleeding, the patient should rest in bed and fast; closely observe changes in the condition, maintain intravenous access and measure central venous pressure. Keep the patient's airway open to avoid suffocation caused by vomiting blood. And take appropriate treatment for the primary disease.

(2) Replenishing blood volume In case of acute massive bleeding, intravenous infusion should be given rapidly to maintain blood volume and prevent a drop in blood pressure. When hemoglobin is lower than 6 g/dl and systolic blood pressure is lower than 12 kPa (90 mmHg), blood transfusion should be considered. Avoid excessive blood transfusion or infusion to prevent acute pulmonary edema or re-bleeding.

(3) Endoscopic treatment has limited hemostatic effect under colonoscopy and small enteroscopy and is not suitable for acute massive bleeding, especially for diffuse intestinal lesions. Specific methods include: argon plasma coagulation (APC), electrocoagulation (including monopolar or multipolar electrocoagulation), cryostasis, thermal probe hemostasis, and spraying of epinephrine, thrombin, leptin and other drugs on the bleeding lesions to stop bleeding. APC, electrocoagulation and other hemostatic methods should not be used for bleeding caused by diverticulum to avoid intestinal perforation.

(4) Minimally invasive interventional treatment: After selective angiography shows the bleeding site, hemostasis treatment can be performed through the catheter. The goal of hemostasis can be achieved in most cases. Although some cases will bleed again during hospitalization, the patient's general condition has improved during this period, creating good conditions for elective surgical treatment. It is worth pointing out that gastrointestinal bleeding caused by intestinal ischemic diseases is contraindicated. Generally speaking, embolization is not recommended for hemostasis in cases of lower gastrointestinal bleeding after arterial catheterization because embolization of the proximal blood vessels can easily cause ischemic necrosis of the intestine, especially the colon.

(5) Surgical treatment: When the cause and site of bleeding are unclear, blind laparotomy is not recommended. Laparotomy may be considered in the following situations: ① Active massive bleeding and hemodynamic instability, arterial angiography or other examinations are not allowed; ② The above examinations did not find the bleeding site, but the bleeding is still ongoing; ③ Similar severe bleeding occurs repeatedly. The operation should be thoroughly and carefully explored, and if necessary, intraoperative endoscopic examination should be performed through the anus and/or enterostomy. It is performed by an endoscopist, with the surgeon assisting in inserting the endoscope and rotating the intestinal tube to flatten the mucosal folds, allowing the endoscopist to obtain a clear field of view, which is conducive to the discovery of small and hidden bleeding lesions. At the same time, the surgeon can sometimes detect lesions from the serosal surface through endoscopic illumination.