Upper and Lower Gastrointestinal Bleeding

  • C. S. Pitchumoni
  • C. S. Pitchumoni
  • C. S. Pitchumoni
  • Alexander Brun


Old age is associated with increasing incidence, morbidity, and mortality from gastrointestinal bleeding. Upper gastrointestinal bleeding presents with hematemesis, melena, or large amount of blood on nasogastric tube lavage and results mainly from peptic ulcers, gastric or esophageal varices, and esophagitis. Diverticulosis, hemorrhoids, colon cancer, polyps, and angioectasias are the main causes of lower gastrointestinal bleeding, which generally manifests as hematochezia. Initial evaluation of the patient with acute gastrointestinal bleeding should include history taking, physical examination with attention to signs of hypovolemia, performance of nasogastric tube lavage, and rectal examination. The history and physical can narrow the differential diagnosis, which can be confirmed and treated by endoscopy. On presentation, blood should be sent for a complete blood count, typing and crossmatching, basic chemistry, liver function tests, and coagulation studies. Resuscitative measures ought to be immediately undertaken during the patient’s assessment in the emergency department.


Anal Fissure Endoscopic Therapy Ischemic Colitis Gastric Varix Proton Pump Inhibitor Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • C. S. Pitchumoni
    • 1
  • C. S. Pitchumoni
    • 2
  • C. S. Pitchumoni
    • 3
  • Alexander Brun
    • 4
  1. 1.Robert Wood Johnson School of Medicine, Drexel University School of MedicinePhiladelphiaUSA
  2. 2.New York Medical CollegeVallhalaUSA
  3. 3.Gastroenterology, Hepatology and NutritionSaint Peter’s University HospitalNew BrunswickUSA
  4. 4.Department of Medicine, Division of GastroenterologyNorth Shore-Long Island Jewish Health SystemNew Hyde ParkUSA

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