Thrombus formation by mechanical tamponade by

thrombus formation by mechanical tamponade, by concentration and activation of platelets and
coagulation factors; this was recently approved in Canada for upper GI bleeds (Woo & Curley,
2018). Epinephrine injection monotherapy is used for stercoral ulcer because of risk of
perforation with electrocoagulation; other hemo-static sprays such as Ankaferd Blood Stopper is
also used for managing post-polypectomy rectal ulcers (Woo & Curley, 2018).
Proton pump inhibitors, for example omeprazole also used for acute upper GI bleed, which can
be given intravenously or orally, given along with local hemostatic therapy helps to minimize the
risk of continued bleeding or re-bleeding, especially for peptic ulcers (Proton pump inhibitors for
acute upper GI bleeding, 2004).

Source of Bleed
There are differences in diagnostic approach because of the wide range of underlying pathology
of GI bleeds; depending on the rate of blood loss, they may be overt, occult or obscure; with
overt is visible, looking like “coffee ground’ emesis, heatochezia or melena; occult/chronic
presents as Hemoccult-positive stools seen with iron deficiency anemia shown on a fecal occult
blood test and obscure GI bleed, is recurrent and source only identified on an endoscopy or
colonoscopy (Kim et al., 2015).
References
Cunha, J., & Bhupinder, A. (2017). Gastrointestinal(GI) bleeding symptoms, treatment, risk
factors. Retrieved from
of_upper_or_lower_gastrointestinal_gi_bleeding_diagnosed
Kim, B., Li, B., Engel, A., Samra, J., Clarke, S., Norton, I., & Li, A. (2015). Diagnosis of
gastrointestinal bleeding: A practical guide for clinicians. Retrieved from
Proton pump inhibitors for acute upper GI bleeding. (2004). Drug and Therapeutics
Bulletin, 42 (6), 41. doi:
Woo, M., & Curley, M. (2018). Hemospray as the initial treatment of alower gastrointestinal
bleed resulting from stercoral ulceration. ACG Case Reports Journal , 5 e49.
doi:10.14309/crj.2018.49