General

Upper GI bleed Vs. Lower GI bleed

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8 Sep 2016 - General
 

How can we differentiate upper gastrointestinal bleeding from lower gastrointestinal bleeding, from patient's sympotms and signs. Usually, patient with upper gastrointestinal bleed will present with frank red blood haematemesis (can be coffee ground vomiting at time), or malaena (passing black tarry stool from the rectum). They can have epigastric pain or discomfort as well. Patient will lower gastrointestinal bleeding usually presented with passing frank blood per rectum. But, soemtime lower GI bleed can present as malaena as well, if the bleeding is from proximal large bowel, expecially caecal bleeding. There will be a drop in haemoglobullin (Hb) for patient suffering from either upper GI or lower GI bleeding.

The patient's history plays a major role in differentiating the point of bleeding, whether it is upper gastrointestinal or lower GI. Sometimes in instances like when the patient vomits fresh blood the clinical features are very suggestive of upper GI bleeding. But if the patient has malena, tar coloured stool it can be difficult to exactly say which part of the GI tract the bleeding is. In that case a thorough history can help identify the likely origin of the bleeding. History could be sugg...
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