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.
One of the common stomach disorders encountered is gastro esophageal reflux also known as heartburn. The stomach contains hydrochloric acid which helps in digestion of the food and subsequently killing ingested microorganisms. The acidity of the gastric HCl is 2M and any increase in the acidity leads to reflux, in which the gastric HCl travels through the cardiac sphincter muscle to the esophagus causing burning sensation and discomfort. Antacids are common choice of drugs which are administered in these conditions as they reduce the acid reflux and peptic ulcer.
Antacids act locally in the stomach region to neutralize the effect of the gastric HCl in order to prevent the onset of peptic ulcer. Most antacids are not absorbed and they are easily excreted in the stool. The predominant forms of chemicals used in the preparation of antacids include sodium bicarbonate, potassium bicarbonate, aluminum hydroxide, aluminum carbonate, magnesium carbonate, magnesium oxide and calcium carbonate. The natural forms of antacids include ginger, bananas, aloe vera, chamomile (used along with tea), carrots and turmeric. The action of antacids on the stomach is carried out throughout the wall to prevent ulcer formation.
Types of antacids
Antacids are recommended depending upon the intensity of the gastric disorder. In normal or mild conditions of acidity, non systemic antacids are recommended as they do not cause much damage. Prolonged administration of systemic antacids may lead to a condition called alkalosis in which the PH of the blood is raised leading to renal failure. Some of the common types of antacids used in the treatment of reflux and peptic ulcers are:
Sodium bicarbonate: It is recommended by many doctors to treat acid reflux and also reduce the acidity of urine and blood. Antacids which contain sodium bicarbonate also contain baking soda and hence it is not recommended for patients having congestive heart failure, hypertension, kidney disorders and gastrointestinal bleeding. Antacids containing sodium bicarbonate should be taken only after meals on a partially full stomach. The side effects include nausea, flatulence, weakness, increased thirst, black stools and irritability.
Aluminum hydroxide: Aluminum hydroxide is widely used as a non-systemic antacid and in most cases is available without prescription. The side effects of aluminum hydroxide include constipation and abdominal discomfort. In order to avoid constipation and abdominal stress, aluminum hydroxide is given in combination with magnesium hydroxide which has laxative properties along with antacid effects The combination of two such compatible antacids helps in sustained action in relieving peptic ulcers and protecting the wall of the stomach.
Calcium Carbonate: These antacids are mainly used in the treatment of indigestion, flatulence along with acidity and more commonly used as it is less expensive than other types of antacids. They are mostly recommended for children below the age of 12. In patients who have a previous history of osteoporosis or any other type of calcium deficiencies, the intake of calcium carbonate in case of acidity also helps in balancing the calcium requirement. If patients have a history of renal calculi or any other allergic reaction, calcium carbonate antacids should be avoided. The major side effect of this antacid is that it interacts with cardiac drugs. Calcium carbonate based antacids usually disintegrate and dissolute in forty minutes.
Drug side effects
Antacids react with many medications; digoxin, isoniazid, quinidine, pseudoephedrine and tetracycline. The potency and absorption of the drug reduces when the antacids interact with the corresponding drugs.
BUN blood test
Healthy kidneys filter urea nitrogen through the urine. The BUN blood test measures the urea nitrogen levels in your blood as an indicator of the efficiency of the kidneys. BUN - Blood Urea Nitrogen blood test indicates the functioning of the kidneys. The BUN concentration is measured by analysis of serum or plasma. It is also done to check for efficiency of dialysis. BUN blood test measures the levels of urea nitrogen in the blood. BUN blood test results can be compared with creatinine test to check for dehydration. BUN - creatinine ratio can throw light on kidney functioning.
BUN blood test levels
Normal BUN blood levels are 7 - 20 mg/dl. Abnormal levels of BUN are usually indicative of renal failure or bleeding into the stomach or intestines. High levels of BUN in the blood can mean congestive heart failure, gastrointestinal bleeding, urinary tract obstruction or myocardial infarction. BUN blood levels are noticed to be higher in diabetics. This is due to accumulated stress on the kidneys over years. This leads to kidney failure and dysfunction. Acute dehydration raised BUN blood levels due to inadequate level of fluids in the body. Lower levels of BUN in the blood may suggest malnutrition or liver failure. Some women notice decrease in BUN level in the third trimester of pregnancy.
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Bibliography / Reference
Collection of Pages - Last revised Date: August 16, 2022