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Hematemesis is the vomiting of blood. [1] This is usually vomit that contains bright red blood. [2] Coffee ground vomiting is similar to hematemesis, but is distinct in not involving bright red blood. [3] Hematemesis must be differentiated from hemoptysis (coughing up blood) and epistaxis (nosebleed). [4] Both of these are more common conditions.
Initial treatment focuses on resuscitation which may include intravenous fluids and blood transfusions. [4] Often blood transfusions are not recommended unless the hemoglobin is less than 70 or 80 g/L. [7] [12] Treatment with proton pump inhibitors, octreotide, and antibiotics may be considered in certain cases.
The strongest predictors of an upper gastrointestinal bleed are black stool, age <50 years, and blood urea nitrogen/creatinine ratio 30 or more. [8] [9] The diagnosis of upper gastrointestinal bleeding is assumed when hematemesis (vomiting of blood) is observed. [citation needed]
2 and increased blood pH) and often hypokalemia (potassium depletion). The hypokalemia is an indirect result of the kidney compensating for the loss of acid. With the loss of intake of food the individual may eventually become cachectic. A less frequent occurrence results from a vomiting of intestinal contents, including bile acids and HCO − 3.
Portal hypertensive gastropathy can also be treated with endoscopic treatment delivered through a fibre-optic camera into the stomach. Argon plasma coagulation and electrocautery have both been used to stop bleeding from ectatic vessels, and to attempt to obliterate the vessels, but have limited utility if the disease is diffuse.
Increase in blood pressure Liver injury − right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
Metformin — a biguanide — is an oral diabetes medication that helps keep blood sugar in check by causing the liver to produce less glucose. It was approved by the FDA in 1994 for the treatment ...
Treatment is indicated if there is active bleeding in the stomach, visible vessels, or an adherent clot. Endoscopy is also helpful in identifying people who are suitable for hospital discharge. Prokinetic agents such as erythromycin and metoclopramide can be given before endoscopy to improve endoscopic view.