Journal of Gastroenterology and Digestive Diseases

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.

Short Communication - Journal of Gastroenterology and Digestive Diseases (2024) Volume 9, Issue 2

The importance of early intervention in digestive bleeding cases

Vitale Tran *

Hospices Civils de Lyon, centre hospitalier Lyon Sud, France

*Corresponding Author:
Vitale Tran
Hospices Civils de Lyon, centre hospitalier Lyon Sud, France
E-mail: vitaletran@frnc.com

Received: 28-Feb-2024, Manuscript No. JGDD-24-136142; Editor assigned: 29-Feb-2024, PreQC No. JGDD-24-136142(PQ); Reviewed: 14-Mar-2024, QC No. JGDD-24-136142; Revised: 20-Mar-2024, Manuscript No. JGDD-24-136142(R); Published: 27-Mar-2024, DOI: 10.35841/jgdd -9.2.198

Citation: : Tran V. The importance of early intervention in digestive bleeding cases. J Gastroenterol Dig Dis.2024;9(2):198

Visit for more related articles at Journal of Gastroenterology and Digestive Diseases

Introduction

Digestive bleeding, whether from the upper gastrointestinal tract (UGIB) or the lower gastrointestinal tract (LGIB), is a serious medical condition that requires prompt recognition and intervention. Early intervention plays a crucial role in improving patient outcomes, reducing complications, and preventing mortality. This article explores the importance of early intervention in digestive bleeding cases, highlighting its impact on diagnosis, treatment, and patient management [1].

Early intervention begins with the prompt recognition of symptoms suggestive of digestive bleeding. These may include: Upper Gastrointestinal Bleeding (UGIB): Hematemesis (vomiting blood), melena (black, tarry stools), hematochezia (fresh blood in stools), and symptoms of anemia (e.g., weakness, fatigue). Lower Gastrointestinal Bleeding (LGIB): Hematochezia (bright red or maroon-colored stools), melena, or rectal bleeding [2].

Laboratory and Imaging Studies: Laboratory Tests: Immediate evaluation of complete blood count (CBC), coagulation profile, and renal function tests to assess for anemia, coagulopathy, and renal impairment. Imaging Studies: Early consideration of imaging studies such as abdominal ultrasound or CT scan to localize the bleeding source and assess for complications [3].

Fluid Resuscitation: Rapid intravenous fluid administration to restore intravascular volume and improve perfusion. Blood Transfusion: Transfusion of packed red blood cells (PRBCs) to correct anemia and stabilize hemoglobin levels [4].

Early Endoscopy: Urgent endoscopy within 24 hours of presentation to identify and treat the bleeding source, such as peptic ulcers, varices, or Mallory-Weiss tears. Endoscopic Hemostasis: Immediate intervention with techniques like injection therapy, thermal coagulation, or mechanical hemostasis (clips or bands) to achieve hemostasis [5].

Colonoscopy: Urgent colonoscopy to identify and treat the bleeding source, including diverticula, angiodysplasia, or colonic polyps. Endoscopic Therapy: Application of hemostatic techniques (injection, thermal, mechanical) during colonoscopy to control bleeding and prevent rebleeding. Proton Pump Inhibitors (PPIs): Early initiation to reduce gastric acid secretion and promote ulcer healing in UGIB [6].

Vasoconstrictors: Administration of medications such as octreotide in cases of variceal bleeding to reduce portal pressure and control bleeding. Indications: Early consideration of surgery in cases of severe, refractory bleeding or complications such as perforation or obstruction. Minimally Invasive Approaches: Advancements in laparoscopic and robotic-assisted surgeries for gastrointestinal bleeding have reduced morbidity and recovery times compared to traditional open surgeries [7].

Early intervention significantly reduces the risk of mortality associated with digestive bleeding, especially in cases of severe hemorrhage or hemodynamic instability. Prompt resuscitation and definitive treatment prevent complications such as hypovolemic shock and multiorgan failure [8].

Early identification and treatment of the bleeding source reduce the likelihood of recurrent bleeding episodes, which can lead to chronic anemia and the need for repeated interventions. Timely diagnosis and management lead to shorter hospital stays and lower healthcare costs by reducing the need for intensive care unit (ICU) admissions and surgical interventions [9].

Initiate rapid intravenous fluid resuscitation and blood transfusion to stabilize hemodynamics and correct anemia. Early Endoscopy: Perform urgent esophagogastroduodenoscopy (EGD) within 12 hours to identify and treat bleeding peptic ulcers. Pharmacologic Therapy: Start PPI therapy to reduce gastric acid secretion and promote ulcer healing [10].

Conclusion

Early intervention is paramount in the management of digestive bleeding, as it allows for prompt diagnosis, stabilization, and treatment of the bleeding source. Through a multidisciplinary approach involving emergency medicine, gastroenterology, surgery, and critical care, healthcare providers can optimize outcomes and improve survival rates for patients with gastrointestinal bleeding. By recognizing the importance of early intervention and implementing timely management strategies, healthcare systems can effectively reduce mortality, prevent complications, and enhance the quality of life for patients affected by this critical condition.

References

  1. Nicoar?-Farc?u O, Han G, Rudler M, et al. Effects of early placement of transjugular portosystemic shunts in patients with high-risk acute variceal bleeding: a meta-analysis of individual patient data. Gastroenterology. 2021;160(1):193-205.

    2. Indexed at,Google Scholar, Cross Ref

  2. Evans RP, Mourad MM, Pall G, et al. Pancreatitis: Preventing catastrophic haemorrhage. World J Gastroenterol. 2017;23(30):5460.

    3. Indexed at, Google Scholar, Cross Ref

  3. Lal P, Thota PN. Cryotherapy in the management of premalignant and malignant conditions of the esophagus. World J Gastroenterol. 2018;24(43):4862.

    4. Indexed at, Google Scholar, Cross Ref

  4. Brown J, Meyer F, Klapproth JM. Aspects in the interdisciplinary decision-making for surgical intervention in ulcerative colitis and its complications. Z Gastroenterol. 2012;50(05):468-74.

    5. Indexed at, Google Scholar, Cross Ref

  5. Chiang KC, Chen TH, Hsu JT. Management of chronic pancreatitis complicated with a bleeding pseudoaneurysm. World J Gastroenterol. 2014;20(43):16132.

    6. Indexed at, Google Scholar, Cross Ref

  6. Sung JJ, Luo D, Wu JC, et al. Early clinical experience of the safety and effectiveness of Hemospray in achieving hemostasis in patients with acute peptic ulcer bleeding. Endoscopy. 2011;43(04):291-5.

    7. Indexed at, Google Scholar, Cross Ref

  7. Edmunds J, Miles S, Fulbrook P. Tongue-tie and breastfeeding: a review of the literature. Breastfeed Rev. 2011;19(1):19-26.

    8. Indexed at, Google Scholar

  8. Zamulko OY, Zamulko AO, Dawson MJ. Introducing GIST and Dieulafoy-Think of Them in GI Bleeding and Anemia. S D Med. 2019;72(11).

    9. Indexed at, Google Scholar

  9. Otani K, Watanabe T, Shimada S, et al. Clinical utility of capsule endoscopy and double-balloon enteroscopy in the management of obscure gastrointestinal bleeding. Digestion. 1962;97(1):52-8.

    10. Indexed at, Google Scholar, Cross Ref

  10. Papaefthymiou A, Koffas A, Laskaratos FM, et al. Upper gastrointestinal video capsule endoscopy: The state of the art. Clin Res Hepatol Gastroenterol. 2022;46(3):101798.

    11. Indexed at, Google Scholar, Cross Ref

Get the App