Upper GI Bleeding (Khoon Ki Ulti, Melena) Treatment in Indore

Understanding Upper GI Bleeding

The digestive tract is a long tube that starts at the mouth and ends at the anus. The food pipe (oesophagus) the stomach and the first part of the small intestine (called the duodenum) are contained in the upper part of this tube. Blood enters the digestive tract if a blood vessel in any of these areas ruptures, tears or erodes. This is known as upper gastrointestinal (GI) bleeding.
Upper GI bleeding is a medical problem that requires prompt attention. Some people lose a little bit of blood over weeks and feel tired but don’t know why. Others bleed suddenly and badly, and can get dizzy, pale or faint within hours. In either case the cause must be found and treated, as in some cases the bleeding point will not close spontaneously.

Dr. Kriti Bansal is a gastroenterologist in Indore and she treats patients with upper GI bleeding. Her approach is to stabilize the patient, then find the exact site of the bleeding with an endoscope, treat it, and then manage the causes so it does not recur. If you are looking for upper GI bleeding treatment in Indore, first step is medical assessment to find out from where the blood is coming.

Khoon Ki Ulti And Melena: Significance Of These Symptoms

There are two signs that most people seek medical help.

• The first is khoon ki ulti, medically termed as hematemesis. If the bleeding is fresh and brisk the blood vomited may be bright red. If blood has been in the stomach for a while, the acid in the stomach changes its color and the vomit looks dark brown or like coffee grounds.
• Second sign is melena. Melena is black, tar-like, sticky stool with a characteristic foul smell. Black comes from blood that has been partially digested as it moves through the intestines. The difference is that black stool that looks like this is not the same as the dark stool you get after eating beet or taking iron tablets, which is usually solid and not the same sticky consistency. If you are not sure, it is better to have it checked.

Some patients have both signs together, some have only one. A single episode of either sign should prompt a visit to a gasteroenterologist in Indore. Treatment of blood vomiting starts with immediate stabilization and an endoscopy to locate the source of bleeding. Melena treatment is same as the way because black stool means there is bleeding somewhere in the upper digestive tract.

Signs and Symptoms of Upper GI Bleeding

The symptoms depend on how quickly and how much blood you lose. The common features are as follows:

1. Vomit that contains blood: The blood in vomit may be red, brown or look like coffee grounds. Some times there are only streaks of blood, in other cases there is a large amount.
2. Black, tarry stool: Melena can happen even in the absence of vomiting. It may be the only outward sign of a slowly bleeding ulcer.
3. Dizziness and fainting: When you lose blood, your blood pressure falls. This can make you feel light-headed, especially if you stand up quickly.
4. Rapid heart rate, cold sweat: The body tries to compensate for the reduced blood volume by increasing the heart rate.
5. Pale skin and weakness: As the blood count goes down, these symptoms appear and are often the first symptoms noticed by family members.
6. Upper abdominal pain or burning: Pain, heaviness or a burning feeling in the upper abdomen is frequently associated with ulcers and gastritis.
7. Breathlessness and fatigue: Slow, hidden bleeding over weeks can lead to anemia, which can cause tiredness, shortness of breath on climbing stairs and poor concentration.

Not everyone with bleeding in the upper part of the GI tract will have pain. Black stool without pain is still a reason to see a doctor.

Causes of Upper GI Bleeding

Upper gastrointestinal bleeding can be caused by many different conditions. Knowing the cause is important, because you can treat it and have a plan for the long term.

• Peptic ulcers: The most common cause is open sores in the lining of the stomach or duodenum. Most are associated with infection with the bacteria Helicobacter pylori or the regular use of anti-inflammatory painkillers such as ibuprofen, diclofenac and aspirin.
• Gastritis and erosions: Inflammation of the stomach lining that can occur after alcohol use, smoking, serious illness or long-term medicine use can cause surface bleeding.
• Esophageal and gastric varices: In people with cirrhosis of the liver, there is an increase in pressure in the veins that carry blood to the liver. Veins in the food pipe and stomach become swollen and can suddenly burst and bleed heavily.
• Mallory-Weiss tear: This is a small tear at the junction of the food pipe and stomach that can happen after repeated or violent vomiting, often after heavy drinking.
• Esophagitis: Long term acid reflux can cause inflammation and ulceration of the lower food pipe.
• Vascular malformations: Abnormal, fragile blood vessels in the stomach or small intestine, such as angiodysplasia or a Dieulafoy lesion, can bleed with little or no warning.
• Tumors: Growths in the esophagus, stomach or duodenum can bleed slowly, which is why unexplained anemia or black stool in older adults should always be followed up.

Complications If Bleeding Goes Untreated

If you ignore black stool or blood in the vomit, the problem can worsen. Heavy bleeding can lead to a sudden drop in blood pressure (shock) and can impair the function of the kidneys, heart and brain by reducing the blood supply to these organs. Iron deficiency anemia is due to slow, repeated bleeding. The person may require a blood transfusion or long term iron therapy.

Bleeding from varices can also cause confusion and worsen liver function in people with liver disease. If left untreated, a bleeding ulcer can grow deeper and eventually break through the wall of the stomach. This is a surgical emergency. Early assessment greatly diminishes the chance of these results.

How Upper GI Bleeding Is Diagnosed

It all begins with a good history for an evaluation. The doctor asks about the color and amount of vomited blood, appearance of the stool, use of painkillers or blood thinners, alcohol intake and any known liver disease or earlier ulcers. Examination includes looking at pulse, blood pressure and symptoms of anemia or liver disease.

Blood tests will include hemoglobin level, platelet count, clotting profile, kidney and liver function tests and blood grouping in case a transfusion is needed. Repeat testing is common as hemoglobin may appear normal in the first hours of rapid bleeding and fall later.

The primary investigation is oesophago-gastro-duodenoscopy or upper GI endoscopy. A thin, flexible tube with a camera and light is passed down the mouth under sedation so the doctor can see the food pipe, stomach and duodenum directly. Endoscopy will show where the bleeding is coming from, how serious it looks and whether treatment can be given in the same sitting. Biopsies may be taken to look for H. pylori or to evaluate an ulcer that looks suspicious. If endoscopy doesn’t find the source, additional tests like capsule endoscopy, CT angiography or a colonoscopy may be scheduled.

Treatment of Upper GI Bleeding

The treatment is performed in stages, the specific stages depending on the severity of the bleeding. Black stool treatment in Indore works on the same principle: find the source, stop the bleeding and then treat the reason it happened.

Stabilising the Patient

Patients with active bleeding are usually admitted to hospital. IV lines are initiated . Fluids are given to help maintain blood pressure . Blood and / or platelets are given if count is low or if unstable . Since acid-reducing medication, usually a proton pump inhibitor, decreases the risk of rebleeding from ulcers, it is started immediately.

Endoscopic Treatment

Once the patient is stable, endoscopy should be performed preferably within the first 24 hours. Depending on what is found, the doctor can apply metal clips to close a bleeding vessel, inject diluted adrenaline to compress it, or use heat or electrical probes to seal it, or spray a hemostatic powder over a wide oozing area. These measures are effective in stopping bleeding in most patients without surgery.

Treatment of variceal bleeding

If the bleeding is from varices, the doctor can perform band ligation, in which small rubber bands are placed around the swollen veins to cut them off. Drugs like terlipressin or octreotide are used to lower the pressure in the portal vein and antibiotics are given to prevent infection. If the bleeding continues, other options include balloon tamponade, stenting of the food pipe or a procedure called TIPS at a specialist center.

Medicines After the Bleed

Acid-suppressing tablets are continued for a few weeks to let the ulcer heal. If H. pylori is found, a course of two antibiotics and an acid suppressant is prescribed and a repeat test is performed later to confirm that the infection has cleared. The pain tablets causing the ulcer are stopped or changed and if aspirin or blood thinning drugs are necessary the doctor liaises with your heart specialist to work out how and when to restart them.

Surgery and radiology

A few patients with bleeding still require endoscopic treatment. In such cases, an interventional radiologist can block the bleeding artery through a thin catheter or a surgeon may do an operation. These steps are only taken if less invasive procedures have failed.

Recovery, Diet and Prevention

Once the bleeding stops, it’s all about healing and prevention. Most patients can start eating soft bland foods within a day or two and then resume a normal diet. Small frequent meals are usually better tolerated than large ones. Avoid spicy and greasy foods, alcohol, smoking and chewing tobacco while your stomach is healing.

Iron tablets or an iron infusion is given to build up the blood count and the hemoglobin is rechecked after a few weeks. Painkillers should only be taken if a doctor has told you to and always with food and also if possible with some kind of medicine to protect your stomach. Cirrhosis patients need regular follow-up endoscopy for surveillance of varices and often are started on long-term prophylactic medications. The best way to avoid a second bleed is to stick to the schedule of follow-up visits and tests.

When to Seek Emergency Care

If you vomit blood or pass large amounts of black or bloody stool, feel faint or confused, have a racing heartbeat, or have severe abdominal pain, go immediately to the nearest emergency department. Do not wait for the symptoms to go away and do not take pain medication or home remedies in the meantime. If possible bring a list of your regular medications, this helps the treating team plan ahead quickly.

Why Choose Dr. Kriti Bansal?

The first thing is to find out where the bleeding is coming from because that will dictate the right treatment, Dr. Kriti Bansal said. We clearly explain to patients and families what is happening and why, taking them through every step from first assessment to endoscopy and recovery.

Her follow-up plan is more than an episode. She checks your medicines, looks for H. pylori, watches the liver when you are suspected of having varices and arranges repeat checks to make sure you are healing. The goal is to treat the root cause so the risk of another bleed is lessened.

For patients coming in for upper GI bleeding, too, there is a care plan that ties emergency care, endoscopic procedures and outpatient follow-up under one doctor, avoiding confusion of who to call when symptoms change. Dr. Kriti Bansal Gastrointestinal Bleeding Specialist in Indore combines emergency evaluation, endoscopic treatment and follow up in one plan.

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Phone: +91-7610102710

Email: drkritigastro@gmail.com