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
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- Winter '16
- Dr. Suresh
- Gastroenterology, Colonoscopy, proton pump inhibitors, gastrointestinal bleeding, Curley, gi bleed