Gastrointestinal+(GI)+Bleeding

//Western Diagnosis//

Definitions
1. hematemesis - vomiting of blood: upper GI through duodenum 2. hematochezia - passage of gross blood by rectum: lower GI 3. melena - passage of black tarry stool: upper GI, SI, ascending colon

Etiology
1. duodenal ulcer, gastric or duodenal erosions, varices, gastric ulcer, diverticular disease, colon CA, colon polyps, IBD, colitis, hemorrhoids, anal fissure, SI neoplasm

History
1. wt. loss, anorexia - neoplasm 2. abd pain better with food, antacids - peptic ulcer 3. dysphagia - esophageal 4. bloody diarrhea, fever, pain - IBD, infectious 5. changes in bowel habits - colon CA, polyps 6. fresh blood on surface of stools - hemorrhoids, rectal lesion 7. drug ingestion - aspirin, NSAID’s 8. trauma

Signs & Symptoms
1. depend on source, rate, underlying disease process 2. weakness, fatigue, pallor, dizziness, chest pain 3. shock, orthostatic pulse or BP changes 4. check nasopharynx for bleeding source

Diagnosis
1. occult blood in stool requires extensive testing 2. nasogastric aspiration 3. panendoscopy - esophagus, stomach, duodenum 4. anoscopy, sigmoidoscopy, colonoscopy

Treatment
1. emergency referral to ER