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A 34-year-old construction worker presents to his Primary Care Provider (PCP) with a chief complaint of...

A 34-year-old construction worker presents to his Primary Care Provider (PCP) with a chief complaint of passing foul smelling dark, tarry stools. He stated the first episode occurred last week, but it was only a small amount after he had eaten a dinner of beets and beef. The episode today was accompanied by nausea, sweating, and weakness. He states he has had some mid epigastric pain for several weeks and has been taking OTC antacids. The most likely diagnosis is upper GI bleed which won’t be confirmed until further endoscopic procedures are performed.

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Expert Solution

Gastrointestinal bleeding is also known as gastrointestinal hemorrhage and it can originate from pharynx to the rectum and can be occult or overt . Gastrointestinal bleeding is as symptom of a disorder of digestive tract. The level of bleeding can range from mild to severe and can be life threatening. Many possible causes of GI bleeding are hemorrhoids,peptic ulcers,tears,or infalmmation in the esophagus,diverticulosis,diverticulitis,Crohns disease,cancer in the colon,stomach or esophagus. Upper gastrointestinal bleeding is gastrointestinal bleeding in the upper gastrointestinal tract commonly defined as been arising from esophagus,stomach or duodenum.The other names of Upper GI bleeding are Upper gastrointestinal hemorrhage,gastrorrhagia,UGI bleed. The factors can contribute to upper gastrointestinal bleeding are Peptic ulcers,gastric erosions,esophageal varices and rarer caused such as gastric cancer. The bacteria Helicobacter pylori and the use of NSAID can cause petic ucer and the peptic ulcer can away the mucose which cause GI bleeding.

Gastrointestinal bleeding is considered as medical emergency . Fluid replacement as well as blood transfusion required.Endoscopy is recommended within 24 hours and bleeding can be stopped by various technique. Recurrent or refractory bleeding may lead to need for surgery ,although this has become uncommon as a result of improved endoscopic and medical treatment.There are many other factors which causes upper gastrointestinal bleeding are in which people are usually stratified in to having either variceal or non variceal sources of upper gastrointestinal hemorrhage.There are three cause : first is  Esophageal causes are esophageal varices,esophagitis,esophageal cancer,esophageal ulcers in which stomach acid can damage esophagus and cause sores and bleeding. The second one is gastric causes including gastric ulcer,gastric cancer,gastritis,gastric varices ,gastric antral vascular ectasia if untreated gastritis can lead to ulcers or worn away areas of the stomach lining that can bleed in the GI tract. The third one is duodenal causes which include duodenal ulcers,vascular malformation,hematobilia,severe superior mesentric artery syndrome.

Symptoms of GI bleeding are black or tarry stool ,brighten red in vomiting ,feling tired,shortness of breathe,cramps in the abdomen,dizziness or faintness.

Nightingale answered 1 year ago
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