GI Haemorrhage

his area needs an integrated approach with other departments such as Medical Gastroenterology, Radiology and Nuclear Medicine to identify the cause of obscure GI bleed. The medical and the surgical teams work together to provide optimal treatment to a GI bleed patient.

Common causes of GI Haemorrhage:

Upper GI Haemorrahge: this usually presents with vomiting of blood and black stools. Common causes are - ulcer disease of the stomach or duodenum, drug induced gastritis (due to pain killers-NSAIDS), liver disease with portal hypertension, abnormal vascular lesions, tumours and cancers of the stomach.

Lower GI Haemorrhage: this usually presents with fresh red to altered blood in stools. It is usually painless and may be massive. The common causes are - malignant lesions of colon, rectum and anus, inflammatory bowel diseases (Ulcerative colitis and Crohns disease), inflammatory (tuberculosis or typhoid), malignant diseases of small intestine, haemorrhoids(piles), diverticulitis.

Obscure GI Haemorrhage: there are some cases where inspite of all the investigations, the cause of GI haemorrhage cannot be ascertained. Here the cause of bleed is frequently from the small intestine which is difficult to diagnose on routine investigations.

At our hospital we have facilities of doing special radiological tests like - enteroclysis, CT or MR enteroclysis and endoscopic tests like : double balloon enteroscopy or capsule endoscopy. Surgical expertise to deal with such cases is available here with facilities of intra operative endoscopy if required.