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How do you know if a patient has a bleeding disorder?
Are there evidence-based guidelines for aging patients with bleeding disorders?
How do you know if bleeding is life threatening?
External bleeding is bleeding that is visible on the outside of the body. Volume and flow are two ways to tell if bleeding is life-threatening. Volume is the amount of blood present. Think about a soda can. Bleeding may be life-threatening when the amount of blood present is equal to about half of what a soda can contains.
- Types of GI Bleeding
- Etiology
- Evaluation and Diagnosis
- Treatment
- GI Bleeding in The Elderly
- Endoscopic Safety
Upper GI Bleeding: Hematemesis is vomiting of red-colored blood and indicates upper GI bleeding, usually from an arterial source or varix. It is considered a medical emergency, and the most vital distinction is whether there is blood loss sufficient to cause shock. The bleeding is similar to dark brown emesis, with granular material that resembles ...
GI bleeding of any cause is more likely and severe in patients with chronic liver disease from alcohol abuse or hepatitis. It also occurs more commonly in patients with hereditary coagulation disorders or in those taking certain drugs. Drugs associated with GI bleeding include heparin, warfarin, aspirin, certain NSAIDs, clopidogrel, and selective s...
The first step in the diagnosis of GI bleeding is to stabilize the patient’s airways and administer IV fluids or transfuse blood. Bloody nasogastric aspirate indicates active upper GI bleeding, but about 10% of patients have no blood in the nasogastric aspirate.4 Then the focus should be on vital signs and any indication for hypovolemia (e.g., tach...
Both hematemesis and hematochezia should be considered an emergency. Admission to an intensive care unit, with consultation by a gastroenterologist and a surgeon, is recommended for all patients with severe GI bleeding. General treatment is directed at maintenance of the airway and restoration of circulating volume. Hemostasis and other treatments ...
In the elderly (age ≥65 years), hemorrhoids and colorectal cancer are the most common causes of minor bleeding. Peptic ulcer, diverticular disease, and angiodysplasia are the most common causes of major bleeding. Approximately 35% to 45% of all cases of acute upper GI hemorrhage occur in elderly persons. These patients increasingly account for the ...
Although upper endoscopy and colonoscopy are generally considered to be safe in the elderly, the risk of complications (including hemorrhage, aspiration pneumonia, myocardial infarction, and perforation) is greater than that with younger patients. Approximately 30% to 40% of patients who undergo GI endoscopy are older than 70 years.4 On an emergenc...
Dec 5, 2015 · Early signs of a bleeding disorder such as bruising are easily dismissed as “senile purpura” or “normal” side effects of drugs they are taking such as antiplatelet agents and anticoagulants. Hemostasis changes with aging as a result of change in coagulation factors, thrombin generation, and platelet function.
- Rebecca Kruse-Jarres
- 2015
Aug 24, 2023 · Summary. Hemorrhage is a term for any type of bleeding, but it's most commonly associated with severe bleeding. External hemorrhages from a cut or wound can be minor or serious. Minor wounds may respond to pressure and stop bleeding, but steady, significant bleeding requires urgent medical attention.
- Nancy Lebrun
Dec 10, 2021 · Evidence-based guidelines for the management of aging patients with bleeding disorders are lacking, largely due to the underrepresentation of older adult patients in clinical trials as well as the rarity of many such bleeding disorders.
- Mouhamed Yazan Abou-Ismail
- 2021/12/12
- 10.1182/hematology.2021000288
Apr 1, 2008 · Bleeding can originate from either the upper or lower gastrointestinal tract, and patients with gastrointestinal bleeding present with a range of symptoms. In the elderly, the nature,...
Symptoms depend on the rate of bleeding as well as the location of the bleed, which can be anywhere on the GI tract, from where it starts — the mouth — to where it ends — the anus. Overt bleeding might show up as: Vomiting blood, which might be red or might be dark brown and look like coffee grounds. Black, tarry stool.
