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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%.
About 75% of people presenting to the emergency department with gastrointestinal bleeding have an upper source. [9] The diagnosis is easier when the people have hematemesis. In the absence of hematemesis, 40% to 50% of people in the emergency department with gastrointestinal bleeding have an upper source. [8] [10] [25]
Blood in stool looks different depending on how early it enters the digestive tract—and thus how much digestive action it has been exposed to—and how much there is. The term can refer either to melena, with a black appearance, typically originating from upper gastrointestinal bleeding; or to hematochezia, with a red color, typically originating from lower gastrointestinal bleeding. [6]
[3] [6] Chronic disease is a risk factor for acute disease. [7] The best method of diagnosis is angiography, with computed tomography (CT) used when that is not available. [1] Treatment of acute ischemia may include stenting or medications to break down the clot provided at the site of obstruction by interventional radiology. [1]
Fecal occult blood testing (FOBT), as its name implies, aims to detect subtle blood loss in the gastrointestinal tract, anywhere from the mouth to the colon.Positive tests ("positive stool") may result from either upper gastrointestinal bleeding or lower gastrointestinal bleeding and warrant further investigation for peptic ulcers or a malignancy (such as colorectal cancer or gastric cancer).
Gastric antral vascular ectasia (GAVE) is an uncommon cause of chronic gastrointestinal bleeding or iron deficiency anemia. [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]
Mallory–Weiss syndrome is a condition where high intra-abdominal pressures causes laceration and bleeding of the mucosa called Mallory-Weiss tears. [1] Additionally, Mallory–Weiss syndrome is one of the most common causes of acute upper gastrointestinal bleeding, counting of around 1-15% of all cases in adults and less than 5% in children.
Commonly the embolism is caused by atrial fibrillation, valvular disease, myocardial infarction, or cardiomyopathy. [ citation needed ] In addition, ischemic colitis is a well-recognized complication of abdominal aortic aneurysm repair, when the origin of the inferior mesenteric artery is covered by the aortic graft.