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Esomeprazole Gastrointestinal Bleeding
Commonly referred to as GI bleeding, this is often a symptom of another underlying disease process. GI bleeding may be profuse, with the vomiting of bright red blood, or it may be identified by the passage of occult blood (only chemically detectable quantities of blood in stools not visible to the naked eye).
COMMON SOURCES FOR GI BLEEDING
1. PEPTIC ULCER DISEASE
2. ESOPHAGITIS WITH EROSIONS, TEARS, OR ULCERS
3. INTESTINAL POLYPS OR CANCERS
4. ULCERATIVE COLITIS
5. DIVERTICULITIS
6. HEMORRHOIDS
7. ANAL FISSURES
8. ESOPHAGEAL VARICES (abnormally large dilated veins in the esophagus, seen in patients who have cirrhosis of the liver).
Common symptoms of GI bleeding include black, dark or tarry stools, vomiting "coffee ground" type material, vomiting bright red blood, passing bright red blood in stools, and blood upon wiping with tissue. Patients with occult, or microscopic blood loss in the stools, may present with additional symptoms of anemia (progressive weakness, lightheadedness or fainting on standing, shortness of breath, and pallor). Evaluation will involve medical history and physical examination (including stool testing for presence of blood). Blood tests (complete blood count) can show the severity of the anemia, indicated by a low red blood cell count. Upper GI endoscopy and lower GI endoscopy are excellent tools, allowing the physician to visually inspect the GI tract through the use of a flexible fiberoptic scope. Stools can be tested chemically for the presence of minute quantities of blood that may indicate a possible GI cancer. Stool test kits are available at your pharmacy for home use. The American Cancer Society guidelines suggest an annual check of the stools for occult blood in males and females over age 50. Due to the potential severity of this problem, most patients with evidence for significant GI bleeding (vomiting blood, black tarry stools, or bright red blood with bowel movements) will require hospitalization for physician evaluation and treatment of the underlying problem. Blood transfusions are reserved for those with more substantial blood loss (life-threatening).
PATIENTS AT RISK TO DEVELOP GI BLEEDING
1. PATIENTS WITH REGULAR ASPIRIN OR ANTI-INFLAMMATORY USE
2. THOSE WITH HEAVY OR REGULAR ALCOHOL USE
3. THOSE WITH LIVER DISEASE (cirrhosis)
4. THOSE ON ANTICOAGULANTS (Coumadin)
5. THOSE WITH BLOOD CLOTTING DISORDERS
. THOSE WITH ISCHEMIC BOWEL DISEASE
7. THOSE IN THE IMMEDIATE POST OPERATIVE PERIOD FOLLOWING ABDOMINAL SURGERY.
8. ELDERLY PATIENTS
9. PATIENTS WITH KNOWN PEPTIC ULCER DISEASE
10. PATIENTS WITH ULCERATIVE COLITIS
11. PATIENTS WITH CROHN'S DISEASE
12. PATIENTS WITH ZOLLINGER-ELLISON SYNDROME
Gastrointestinal bleeding ALWAYS requires prompt physician evaluation.
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