Encyclopedia of Health and Medicine

gastrointestinal bleeding 51
TREATMENTS FOR GERD
Medical Methods Surgical Methods Lifestyle Methods
H2 BLOCKERS fundoplication WEIGHT LOSS AND WEIGHT MANAGEMENT
PPIS endoscopic gastroplasty elevate head of bed
antibiotics for H. PYLORI
SMOKING CESSATION
ANTACIDS
avoid CAFFEINE and ALCOHOL
reduce carbonated beverages
stay upright for 2 hours after meals
sleep lying on the left side
avoid NSAIDS and aspirin
most common complications after surgery are
INFECTION and difficulty swallowing.
Risk Factors and Preventive Measures
Doctors are uncertain what causes GERD to
develop, though various factors appear to contribute.
Among them are
• OBESITY
• cigarette smoking
• H. pylori
• ASTHMA
• eating within two hours of going to bed
• heavy ALCOHOL consumption
Preventive measures include avoiding or minimizing
factors associated with GERD as well as
eating smaller meals and getting regular physical
exercise, which helps maintain effective PERISTALSIS
and gastrointestinal motility (movement of food
through the gastrointestinal tract).
See also ACHALASIA; BARRETT’S ESOPHAGUS;
ENDOSCOPY; ESOPHAGITIS.
gastrointestinal bleeding Gross (obvious) or
occult (microscopic) bleeding along any section of
the gastrointestinal tract. Gross bleeding generally
is obvious. Occult bleeding often occurs with
intestinal polyps. FECAL OCCULT BLOOD TEST (FOBT) is
one method used to detect microscopic BLOOD in
the stool. Several kinds of FOBTs are available for
home use, though it is imperative to follow up
with the doctor when the results are questionable
or positive.
Gastrointestinal bleeding can result from
numerous conditions as well as excessive doses of
anticoagulant medications or irritation from medications
such as aspirin and NONSTEROIDAL ANTI-
INFLAMMATORY DRUGS (NSAIDS). The most common
sites are the STOMACH, DUODENUM, sigmoid COLON,
and RECTUM. There are three ways in which gastrointestinal
bleeding presents:
• hematemesis is the VOMITING of bright red
blood, signaling bleeding from the upper gastrointestinal
tract (usually the ESOPHAGUS, stomach
or duodenum)
• hematochezia is the passing of bright red blood
rectally, indicating bleeding from the lower gastrointestinal
tract (usually the sigmoid colon or
rectum) or from HEMORRHOIDS
• melena is the passing of dark, tarry stools that
signal bleeding from the upper gastrointestinal
tract
All gastrointestinal bleeding requires medical
evaluation to determine its cause. Persistent bleeding,
even when the amounts of blood appear small,
results in ANEMIA. The diagnostic path may include
ENDOSCOPY of the upper and lower gastrointestinal
tracts, esophagogastroduodenoscopy (EGD) and
COLONOSCOPY respectively, as well as BARIUM SWAL-
LOW and BARIUM ENEMA. Treatment targets the
underlying condition, and may include BLOOD
TRANSFUSION when the blood loss is significant.
ANAL FISSURE
COLITIS
ESOPHAGEAL CANCER
HEMORRHOIDS
INTESTINAL POLYP
STOMACH CANCER
CONDITIONS THAT CAN CAUSE
GASTROINTESTINAL BLEEDING
BARRETT’S ESOPHAGUS
DIVERTICULAR DISEASE
GASTRITIS
INFLAMMATORY BOWEL DISEASE (IBD)
PEPTIC ULCER DISEASE