Lower Gastrointestinal Bleeding
Statistics show that annually there will be almost 30 cases in 100, 000 population of gastrointestinal hemorrhage caused by lower gastrointestinal bleeding. Although upper gastrointestinal bleeding is more common then lower gastrointestinal bleeding it has been stated that almost half of the patients that will suffer from it, will not notice or seek medical help. LGIB will have a large palette of symptoms that will include trivial hematochezia up to a massive hemorrhage with shock.
In the medical field lower gastrointestinal bleeding will be described as originating from the ligament of Treitz and will have as outcome instability among the vital organs with anemia symptoms and significant blood loss and in need of blood transfusion. It will be catalogued into three groups depending on the amount of bleeding up to massive hemorrhage that will be life threatening and will require a minimum of three units of blood transfusion.
Massive lower gastrointestinal bleeding can be defined in shock and hemodynamic instability, passage of large amounts of red of up to brown blood through the rectum, a need in transfusion of a minimum two units of packed red blood cells, a decrease in hematrocrit level up to 6g/dL, type of bleeding that will continue for three days and the possibility of rebleeding in a maximum of a week duration.
The mortality rate in patients that will suffer from lower gastrointestinal bleeding will be up to 20%, depending solely on the patient’s age and medical history. Patients that will have a need of urgent surgery or have suffered trauma or sepsis have higher chances in complications arising.
Studies show that lower gastrointestinal bleeding will be more frequent in men then in women but there is no decisive proof as to why. Due to the development in therapeutic colonoscopy, diagnosis and interventional angiography, the need for surgical treatment has diminished. Also health care costs have been brought to a minimum because of the effective management with the less invasive procedures that are partaken and most importantly the mortality rate has lowered as well.
In treating lower gastrointestinal bleeding, the physician must have into account three things: initial assessment and resuscitation, finding the bleeding site and according therapeutical treatment in order to stop the bleeding. This will depend solely on the gravity of the patient’s state, the rate of bleeding, the expertise of the clinic and the procedures that will be partaken.
In the case of surgery, it is important to localize the bleeding before and try to reduce or stop it because segmental colectomies associated with massive bleeding is statistically known as one of the highest mortality and morbidity rate in patients.
One of the most important symptoms that a patient will have in suffering from massive lower or upper gastrointestinal bleeding will be blood in the stool. Also severe vomiting and anemia could appear and it is suggested that the patient will urgently consult a doctor due to the implications that such a condition may have if left untreated.
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