Vomiting of Blood, (Hematemesis) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Vomiting of Blood, Diagnosis and Treatment and Related Diseases

When a person vomits blood in front of you, it can be very frightening sight to see and worse still if after the vomiting of blood he or she collapses in front of you.
This symptom is regarded as a medical emergency.

Vomiting of Blood (Hematemesis) is medically depicted as bleeding within the upper gastrointestinal tract that consists of the mouth, throat, gullet (esophagus), stomach or the first part of the small intestine (duodenum).
The bleeding can be in the form of blood in the vomit (hematemesis) or in the form of black colored stools (melena).
This symptom is normally due to a disorder within the upper gastrointestinal tract.
Vomiting blood is throwing up the contents of the upper GI tract that contains blood.
Vomited blood may look like either a bright red or dark red color.
The vomited material may be mixed with food or it may be pure blood only.
It may be hard to differentiate between vomiting blood and coughing up blood (from the lung) or a nosebleed.
In the patient who may be bleeding profusely and need immediate treatment, directed questions are appropriate such as:
1. If blood or clots were present in the vomitus,
2. If the vomitus looked brown like coffee grounds indicating the probable presence of blood.
A bloody appearance is readily identified as hematemesis but the coffee-ground manifestation will not be identified without direct questioning.
Sometimes hemoptysis or vomiting of swallowed blood from epistaxis (nose bleeds) can be confused with hematemesis.
Hemoptysis is linked with coughing and is bright, foamy red in color.
The patient with profuse epistaxis is normally aware that a nosebleed has occurred.
In many patients the bleeding will stop quite rapidly but in some patients it can become severe and threatening to life.
All vomiting of blood (hematemesis) should be regarded as a medical emergency and should be sent to the hospital as soon as possible because of the danger of severe loss of blood and hypo-volemic shock (shock from low blood volume).
There is an estimated risk of death in 11% of patients.
Causes
There are different forms of bleeding:
1. Dark blood
This is often called as a 'coffee ground' color.
This indicates that the bleed has been comparatively slow.
The blood has been in contact with stomach acid long enough for the acid to turn the blood a dark brown color.
The bleeding in this circumstance may not been heavy.
It may become heavy at a later time.
2. Bright red blood
A large amount of bright red blood indicates a rapid and large bleed that may be direct from the stomach, upper small intestine, gullet or even mouth.
There is a range of different causes
1. Bleeding ulcer in the stomach, duodenum, or esophagus
2. Blood clotting disorders
3. Defects in the blood vessels of the GI tract
4. Swallowing blood (e.g., after a nosebleed)
5. Tumors of the mouth, throat, stomach or esophagus
6. Bleeding from the gullet (esophagus)
Esophageal varices
Varices are widened, swollen blood vessels in the lining of the esophagus.
They are due to the complications of liver cirrhosis.
Scarred liver tissue obstructs blood flow through the liver and causes the veins to swell and bleed in the gullet
7.Mallory-Weiss syndrome is bleeding caused by a tear in the lining of the esophagus or stomach
8. Bleeding peptic ulcer is the most frequent cause of blood vomiting
Diagnosis:
Esophagogastroduodenoscopy (EGD) can do an internal examination of the esophagus, stomach and duodenum
Treatment
Hematemesis suggests an upper gastrointestinal bleeding and emergency treatment:
Blood transfusions
EGD with laser to stop bleeding from the stomach
Medicines
Surgery

TABLE OF CONTENT
Introduction
Chapter 1 Vomiting of Blood
C

• Language: English
• Publisher: Kenneth Kee
• Release date: Aug 4, 2019
• ISBN: 9780463165454

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Vomiting of Blood,

(Hematemesis)

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2019 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Vomiting of Blood, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Vomiting of Blood)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Vomiting of Blood (Hemetemesis)

When a person vomits blood in front of you, it can be very frightening sight to see and worse still if after the vomiting of blood he or she collapses in front of you.

This symptom is regarded as a medical emergency.

What is Vomiting of Blood (Hematemesis)?

Vomiting of Blood (Hematemesis) is medically depicted as bleeding within the upper gastrointestinal tract that consists of the mouth, throat, gullet (esophagus), stomach or the first part of the small intestine (duodenum).

The bleeding can be in the form of blood in the vomit (hematemesis) or in the form of black colored stools (melena).

This symptom is normally due to a disorder within the upper gastrointestinal tract.

Vomiting blood is throwing up the contents of the upper GI tract that contains blood.

Vomited blood may look like either a bright red or dark red color.

The vomited material may be mixed with food or it may be pure blood only.

It may be hard to differentiate between vomiting blood and coughing up blood (from the lung) or a nosebleed.

In the patient who may be bleeding profusely and need immediate treatment, directed questions are appropriate such as:

1. If blood or clots were present in the vomitus,

2. If the vomitus looked brown like coffee grounds indicating the probable presence of blood.

A bloody appearance is readily identified as hematemesis but the coffee-ground manifestation will not be identified without direct questioning.

Hematemesis indicates that the bleeding is from the upper gastrointestinal tract normally from the esophagus, stomach or proximal duodenum.

a. Sometimes hemoptysis or vomiting of swallowed blood from epistaxis (nose bleeds) can be confused with hematemesis.

Hemoptysis is linked with coughing and is bright, foamy red in color.

The patient with profuse epistaxis is normally aware that a nosebleed has occurred.

b. In cases of black stools, melenic stools are shining black in color and sticky.

Other substances, such as iron or bismuth can change the color of the stool black but not shining.

A melenic stool usually means upper gastrointestinal hemorrhage,

In the meantime the immediate treatment of hypo-volemia is instituted by insertion of an intravenous drip of dextrose-saline or blood.

The conditions that induce vomiting of blood can also produce blood in the stool.

Hematochezia is the passage of fresh blood per anus, normally in or with stools.

Vomiting of blood is a medical emergency.

In many patients the bleeding will stop quite rapidly but in some patients it can become severe and threatening to life.

All vomiting of blood (hematemesis) should be regarded as a medical emergency and should be sent to the hospital as soon as possible because of the danger of severe loss of blood and hypo-volemic shock (shock from low blood volume).

There is an estimated risk of death in 11% of patients.

What are the causes of Vomiting of Blood (Hematemesis)?

Causes

There are many possible causes of Vomiting of Blood.

Pathophysiology

The upper GI (gastrointestinal) tract includes the mouth, throat, esophagus (swallowing tube), stomach and the duodenum (first part of the small intestine).

Blood that is vomited may come from any of these organs.

Food passes down the esophagus into the stomach.

The stomach makes acid which is not necessary but assists to digest food.

After being combined with acid in the stomach, food passes into the duodenum, to be digested.

There are different forms of bleeding:

1. Dark blood

This is often called as a 'coffee ground' color.

This indicates that the bleed has been comparatively slow.

The blood has been in contact with stomach acid long enough for the acid to turn the blood a dark brown color.

The bleeding in this circumstance may not been heavy.

It may become heavy at a later time.

2. Bright red blood

A large amount of bright red blood indicates a rapid and large bleed that may be direct from the stomach, upper small intestine, gullet or even mouth.

Melena

Melena is the medical term for old, dark blood in stools or feces.

If there is melena, the stools become very dark or black.

There is often a tar-like consistency.

Vomiting blood and having melena are symptoms that frequently happen together.

Having both symptoms together indicates that the patient has lost a lot of bleeding into the GI tract.

Vomiting that is very forceful or continues for a very long time may produce a tear in the small blood vessels of the throat.

This may induce streaks of blood in the vomit.

Swollen veins in the walls of the lower part of the esophagus, and sometimes the stomach, may start to bleed.

These veins (called varices) occur in people with severe liver damage.

Causative Factors

There is a range of different causes

1. Bleeding ulcer in the stomach, first part of the small intestine, or esophagus

2. Blood clotting disorders

3. Defects in the blood vessels of the GI tract

4. Swallowing blood (e.g., after a nosebleed)

5. Tumors of the mouth, throat, stomach or esophagus

Bleeding from the gullet (esophagus)

Esophageal varices

Varices are widened, swollen blood vessels in the lining of the esophagus or stomach.

They are due to the possible complications of liver cirrhosis.

In cirrhosis, scarred liver tissue obstructs blood flow through the liver.

This induces a backflow in the vein that takes blood from the gut to the liver (the portal vein).

The raised pressure pushes back into the gut and induces the veins to swell in the gullet.

The swellings are quite fragile and may burst and bleed heavily into the gullet.

Esophagitis

Inflammation of the esophagus (esophagitis) is often due to acid reflux from the stomach (gastro-esophageal reflux disease (GERD).

The inflamed esophagus also sometimes bleeds.

Esophageal cancer sometimes induces bleeding into the esophagus.

Mallory-Weiss syndrome

Mallory-Weiss syndrome is bleeding produced by a tear in the lining of the esophagus or stomach.

The tear can be produced by