Gastrointestinal Bleeding

Gastrointestinal Bleeding or GI bleeding refers to bleeding from any part of the gastrointestinal tract, from the mouth and esophagus to the stomach or intestines. Gastrointestinal bleeding can occur due to infection or medications that damage tissues leading to bleeding. GI bleeding needs to be monitored carefully and attended to. Upper Gastrointestinal bleeding can result from gastritis or peptic ulcers. Lower GI bleeding is often due to diverticulitis, polyps, anal fissures or hemorrhoids.

Acute GI bleeding manifests in bloody bowel movements and vomiting of blood. There is fatigue and weakness. The patient suffering GI bleeding may suffer pain in the abdomen. A person suffering from gastrointestinal bleeding experience thirst, low blood pressure and dizziness. The patient may notice black tarry stools.

Laboratory tests, Endoscopy and rectal examinations may be needed to determine the source of the gastrointestinal bleeding. Excessive bleeding can lead to anemia. In severe cases, it can lead to shock and may need hospitalization for further treatment. There might be need for blood transfusion. Upper GI bleeding can be treated with injection of chemicals. Medicines are then prescribed to prevent the bleeding from recurring. If polyps or hemorrhoids are the cause for gastrointestinal bleeding, they are surgically removed.

Potassium Gluconate

This is a potassium supplement useful in those prone to low blood potassium. Its side effects include numbness and tingling of the extremities, confusion, weakness, arrhythmia, ECG changes, nausea, vomiting, diarrhea, abdominal pain, GI ulcerations, GI bleeding, intestinal obstruction, and intestinal perforation.

Using potassium gluconate

1. Should not be used in cases of severe kidney disease, acute dehydration, or those who are using potassium sparing diuretics (e.g. spironolactone, triamterene).
2. Enteric coated potassium tablets cannot be recommended due to increased risk of GI bleeding and ulceration.
3. Minimize GI symptoms by taking this medication with food.

Adult and adolescent dose: oral, elixir, 10-20 mEq of potassium diluted in one-half glass of cold water or juice, two to four times a day; or 5-10 mEq potassium in tablet form, two to four times a day; dosage adjusted to need (up to 100 mEq potassium per day).

Barium Swallow

Barium Swallow or Upper GI series is a radiological test that allows visual examination of the esophagus, stomach, duodenum and small intestine. Nothing should be eaten for about 6 hours prior to the test. Typically, double contrast barium swallow is used. The patient is made to swallow a barium drink after swallowing an effervescent agent. The barium creates a temporary coating on the lining of the upper GI tract. Then he is asked to stand and lie in different positions to spread the liquid. An x-ray machine then takes pictures. Fluoroscopy is often used during a barium swallow.

After this test, patients are asked to drink extra fluids and water to relieve the bowels of the barium. Constipation or fecal impaction may occur if the barium isn't completely eliminated from the body. This diagnostic test is used for detecting dysphagia, hernia, peptic ulcer disease, GERD (Gastro Esophageal Reflux Disease), achalasia, generalized epigastric pain and suspected perforation.