Thursday, June 30, 2016

Most Common Diseases of 50 Plus - Upper gastrointestinal disorders: Upper gastrointestinal bleeding - The Symptoms and Diagnosis

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

           Upper gastrointestinal (GI) diseases

The prevalence of upper gastrointestinal (GI) diseases is increasing in subjects aged 65 years and over. Pathophysiological changes in esophageal functions that occur with aging may, at least in part, be responsible for the high prevalence of
1. Gastro-esophageal reflux disease (GERD) in old age.

2. The incidence of gastric and duodenal ulcers and their bleeding complications is increasing in old-aged populations worldwide.

3. H. pylori infection in elderly patients with H. pylori-associated peptic ulcer disease and severe chronic gastritis.

4. Almost 40% of GU and 25% of DU in the elderly patients are associated with the use of NSAID(1) and/or aspirin(2).(a)

            Upper gastrointestinal bleeding 

Upper gastrointestinal bleeding (UGIB) is defined as hemorrhaging derived from a source proximal to the ligament of Treitz. It is life threatening and considered as medical emergency, which is followed by high mortality rate, ranging from 6 to 15% in spite of modern diagnostic methods and treatment.

                The  Symptoms and Diagnosis

The SymptomsAcccording to the study of a total of 124 patients were eligible for inclusion, 71 (57%) of whom were male. A total of 63 (51%) presented with blood in stool and 53 (43%) with bloody emesis; 8 (6%) had blood in both emesis and stool. A total of 31 (25%) patients had a lower GI bleed, 88 (70%) had an upper, and 5 (4%) had both upper and lower bleeding sources. The mean BUN level was 24 mg/dL, the mean Cr level 1.03 mg/dL, and the mean BUN/Cr ratio was 24. The mean hemoglobin (Hb) level was 11.3 g/dL, the mean Hct was 32 g/dL, and 51% required transfusion. Upper GI bleeding was significantly correlated with age younger than 50 (P = .01) and male gender (P = .01; 
odds ratio, 3.13)(15).
1. Blood vomiting looks like coffee grounds(15).
2. Blood in stool
3. Light head, Fatigue, Generalized weakness and fainting as a result of massive blood loss
4. Abdominal pain
5. Constipation
6. Diarrhea
7. Gastroesophageal reflux disease (GERD)
8. Etc.

The Diagnosis
According to the study by Georgia Health Sciences University, Rapid assessment and resuscitation of upper gastrointestinal bleeding should precede the diagnostic evaluation in unstable patients with severe bleeding. Risk stratification is based onclinical assessment and endoscopic findings. Early upper endoscopy (within 24 hours of presentation) is recommended in most patients because it confirms the diagnosis and allows for targeted endoscopic treatment, including epinephrine injection, thermocoagulation, application of clips, and banding.Endoscopic therapy results in reduced morbidity, hospital stays, risk of recurrent bleeding, and need for surgery. Although administration of proton pump inhibitors does not decrease mortality, risk of rebleeding, or need forsurgery, it reduces stigmata of recent hemorrhage and the need for endoscopic therapy(16).

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