Gastrointestinal bleeding

The importance of the digestive system to human health is self-evident. All three meals a day must go through the digestive system. If there is something wrong with the digestive system, you must pay great attention to it, as it is an indicator of your health. Excluding mechanical injury and bleeding, if gastrointestinal bleeding is found, this is also a symptom of gastrointestinal disease. We must find the cause and actively treat it. A healthy digestive system can make your daily life easier.

The human digestive tract is divided into the upper digestive tract and the lower digestive tract. There are many causes of gastrointestinal bleeding. It may be caused by inflammation, mechanical injury, vascular disease, tumor, etc. of the digestive tract itself, or it may be caused by lesions of adjacent organs and systemic diseases involving the digestive tract and causing bleeding. How should we treat gastrointestinal bleeding?

1. General treatment: Rest in bed; observe the patient's complexion and limb skin to see whether it is cold, wet or warm; record blood pressure, pulse, blood loss and hourly urine output; maintain venous energy and measure central venous pressure. Keep the patient's airway open to avoid suffocation caused by vomiting blood. Those with heavy bleeding should fast, while those with light bleeding can take appropriate liquid food. Most patients often have fever after bleeding, and generally do not need to use antibiotics.

2. Replenish blood volume : When hemoglobin is lower than 9g/dl and systolic blood pressure is lower than 12kPa (90mmHg), sufficient amount of whole blood should be transfused immediately. Patients with cirrhosis and portal hypertension should beware of the possibility of rebleeding caused by increased portal vein pressure due to blood transfusion. Avoid excessive blood transfusion or infusion to prevent acute pulmonary edema or re-bleeding.

3. Hemostasis treatment for massive upper gastrointestinal bleeding

(1) Cooling of the stomach.

(2) Oral hemostatic agents.

(3) Inhibit gastric acid secretion and protect gastric mucosa.

(4) Stop bleeding under direct endoscopic vision.

(5) Non-surgical treatment of esophageal varicose bleeding.

4. Treatment of lower gastrointestinal bleeding

Lower gastrointestinal bleeding is a common intestinal disease. The main symptom is bloody stools. If bloody stools occur for a long time, it will cause serious consequences.

(1) The general principle of treatment is to determine the treatment plan according to the different causes. When the diagnosis cannot be clearly determined, anti-shock treatment should be actively given. The patient should rest in an absolute supine position, fast or eat a low-residue diet, and be given sedatives if necessary. Administer hemostatic agents intravenously or intramuscularly. During treatment, blood pressure, pulse and urine volume should be closely monitored. Pay attention to the abdominal condition, record the frequency and amount of black stools or bloody stools, and regularly check hemoglobin, red blood cell count, hematocrit, urine routine, blood urea nitrogen, creatinine, electrolytes, liver function, etc.

(2) Surgical treatment: Blind laparotomy is not recommended when the cause and site of bleeding are unclear. Laparotomy may be considered in the following situations: ① There is still active massive bleeding and hemodynamic instability, and TCR-BCS, angiography or other examinations are not allowed; ② The above examinations do not find the bleeding site, but the bleeding is still ongoing; ③ Similar severe bleeding occurs repeatedly. During the operation, a comprehensive and careful exploration should be performed, the digestive tract should be carefully palpated throughout, and the intestines should be brought out. Combined with transillumination under light, small intestinal tumors or other lesions may sometimes be discovered. If no lesion is found (accounting for about 1/3), intraoperative endoscopic examination can 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.

Minor ailments should not be ignored. Like gastrointestinal bleeding. Sometimes, gastrointestinal bleeding is easily mistaken for a temporary hemorrhoid problem, and it can be cured by eating less spicy food. In fact, this is not the case. You should check it carefully before you can feel at ease. In order to prevent gastrointestinal bleeding, we should pay attention to the regular rhythm of life, eat three meals a day on time, get up early and go to bed early, drink plenty of water, eat more fruits and vegetables, and eat less spicy and fried foods.