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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]
Peptic ulcer disease is when the inner part of the stomach's gastric mucosa (lining of the stomach), the first part of the small intestine, or sometimes the lower esophagus, gets damaged. An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer. [1]
The symptoms vary from the severity of the disorder. The most classic sign of AEN is the dark pigmentation of esophageal mucosa in an upper endoscopy, usually viewed as an ulcer or as an infectious disease. [6] Necrosis can be found mostly between the three distals of the esophagus, but stops abruptly at the gastroesophageal junction. [2]
Cameron lesions are usually found in older adults with anemia symptoms such as fatigue, shortness of breath, and appearing pale. Blood tests in iron deficiency show low hemoglobin, microcytic hypochromic red cells, and low iron-binding saturation and ferritin levels. The lesions are visualized by esophagogastroduodenoscopy.
These lesions are twice as common in men, and often occur in older individuals (over 50 years of age) with multiple comorbidities, including hypertension, cardiovascular disease, chronic kidney disease, and diabetes. Dieulafoy's lesions present in individuals with an average age of 52 years. [1]
About half of cases are due to peptic ulcer disease (gastric or duodenal ulcers). [3] Esophageal inflammation and erosive disease are the next most common causes. [3] In those with liver cirrhosis, 50–60% of bleeding is due to esophageal varices. [3] Approximately half of those with peptic ulcers have an H. pylori infection. [3]
In order to open the stricture, a surgeon can insert a bougie – a weighted tube used to dilate the constricted areas in the esophagus. [3] It can sometimes be treated with other medications. For example, an H2 antagonist (e.g. ranitidine ) or a proton-pump inhibitor (e.g. omeprazole ) can treat underlying acid reflux disease.
Some people also experience a sensation known as globus esophagus, where it feels as if a ball is lodged in the lower part of the esophagus. The following are additional diseases and conditions that affect the esophagus: Achalasia [1] Acute esophageal necrosis; Barrett's esophagus; Boerhaave syndrome; Caustic injury to the esophagus; Chagas disease