GIT Bleeding

• Causes of upper gastrointestinal bleeding in adults

  • Peptic ulcer
  • Varices (abnormally dilated vessels)
  • Arteriovenous malformations
  • Carcinoma
  • Oesophageal (Mallory-Weiss) tear
• Management strategies for upper gastrointestinal bleeding in adults

  • Establishing two IV bore lines
  • Oxygen therapy
  • Frequent monitoring of blood pressure and pulse
• Symptoms of upper gastrointestinal bleeding in adults

  • Abdominal pain
  • Melena
  • Haematemesis
  • Hypotension
• Treatment for upper gastrointestinal bleeding in adults

  • Cessation of NSAIDs and anticoagulant therapy (while maintaining antiplatelet therapy such as Abciximab and tirofiban)
  • Blood transfusion
  • Banding/stenting for varices
  • Haemostatic methods
  • Triple/quadruple therapy (Triple therapy: PPI + metronidazole/amoxicillin + clarithromycin; Quadruple therapy: PPI + bismuth subsalicylate + metronidazole + tetracycline) for gastric ulcers
  • Balloon tamponade as necessary
• Clinical signs of upper gastrointestinal bleeding in adults

  • Tachycardia
  • Hypotension
  • Abdominal tenderness
  • Peritoneal irritation
  • Iron-deficiency anemia
• Diagnostic techniques for upper gastrointestinal bleeding in adults

  • GIT bleeding scintigraphy
  • Endoscopy
  • Gastroscopy
  • Biopsy (for H. pylori)
  • Proctoscopy
  • Sigmoidoscopy/colonoscopy
  • Angiography
  • CT scans (for tumors)
  • Capsule endoscopy
• Factors contributing to pathogenesis of upper gastrointestinal bleeding in adults

  • NSAID use
  • Anticoagulant use
  • Antiplatelet use
  • Liver disease
  • Alcohol misuse
  • Previous gastrointestinal bleeding
  • Coagulopathy
• Differential diagnosis considerations for upper gastrointestinal bleeding in adults

  • Gastritis
  • Oesophagitis
  • Malignancy
• What are some common causes of upper gastrointestinal bleeding in adults?

  Peptic ulcer, varices, arteriovenous malformations, carcinoma, and oesophageal tear
• What factors are involved in the pathogenesis of upper gastrointestinal bleeding?

  Factors such as NSAID use, anticoagulant use, antiplatelet use, liver disease, alcohol misuse, previous gastrointestinal bleeding, and coagulopathy.
• What clinical signs may indicate upper gastrointestinal bleeding?

  Clinical signs may include tachycardia, hypotension, abdominal tenderness, peritoneal irritation, and iron-deficiency anemia.
• What are some common symptoms of upper gastrointestinal bleeding?

  Symptoms include abdominal pain, melena, haematemesis, and hypotension.
• What imaging techniques are typically used in the diagnosis of upper gastrointestinal bleeding?

  Imaging techniques such as GIT bleeding scintigraphy, endoscopy, gastroscopy, biopsy (for H. pylori), proctoscopy, sigmoidoscopy/colonoscopy, angiography, CT scans (for tumors), and capsule endoscopy.
• What conditions should be considered in the differential diagnosis of upper gastrointestinal bleeding?

  Conditions such as gastritis, oesophagitis, and malignancy should be considered.
• What are some management strategies for upper gastrointestinal bleeding?

  Management strategies include establishing two IV bore lines, oxygen therapy, and frequent monitoring of blood pressure and pulse.
• How is treatment approached for upper gastrointestinal bleeding?

  Treatment involves cessation of NSAIDs and anticoagulant therapy (while maintaining antiplatelet therapy such as Abciximab and tirofiban), blood transfusion, banding/stenting for varices, hemostatic methods, and triple/quadruple therapy for gastric ulcers.
• What is included in triple therapy for gastric ulcers?

  Triple therapy includes a proton pump inhibitor (PPI) combined with metronidazole/amoxicillin and clarithromycin.
• In what situations might balloon tamponade be used in the treatment of upper gastrointestinal bleeding?

  Balloon tamponade may be used as necessary in cases of severe bleeding to provide temporary control and stabilization.