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Barrett's esophagus occurs due to chronic inflammation. The principal cause of chronic inflammation is gastroesophageal reflux disease, GERD (UK: GORD). In this disease, acidic stomach, bile, and small intestine and pancreatic contents cause damage to the cells of the lower esophagus.
An upper GI bleed is more common than lower GI bleed. [2] An upper GI bleed occurs in 50 to 150 per 100,000 adults per year. [8] A lower GI bleed is estimated to occur in 20 to 30 per 100,000 per year. [2] It results in about 300,000 hospital admissions a year in the United States. [1] Risk of death from a GI bleed is between 5% and 30%.
[1] [2] The condition is associated with dilated small blood vessels in the gastric antrum, which is a distal part of the stomach. [1] The dilated vessels result in intestinal bleeding. [3] It is also called watermelon stomach because streaky long red areas that are present in the stomach may resemble the markings on watermelon. [1] [2] [3] [4]
Spots of fresh or clotted blood were seen on the lesions in 25% of persons with anemia compared to 7% without anemia, also a significant difference, p<0.05. In the 109 persons in this study, 15 had reflux esophagitis, 11 had peptic ulcers, and 7 had Barrett's esophagus, but none of these findings correlated with anemia. Thus, in people with ...
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. [8] [10]
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.
Unexplained anemia (usually along with a colonoscopy) Upper gastrointestinal bleeding as evidenced by hematemesis or melena; Persistent dyspepsia in patients over the age of 45 years; Heartburn and chronic acid reflux – this can lead to a precancerous lesion called Barrett's esophagus; Persistent emesis – vomiting; Dysphagia – difficulty ...
A condition in which the lining of the esophagus changes to look more like the lining of the intestine and increases the risk of developing esophageal cancer. [22] There are no specific symptoms although symptoms of GERD may be present for years prior as it is associated with a 10–15% risk of Barrett's esophagus. [22]