The determination of acute gastric hemorrhage is mainly based on acute hematemesis and black stool. Generally the bleeding is not more than 500 milliliters, mostly vomiting blood, there are also predominantly for blood. The patient has a feeling of nausea before vomiting blood, and a feeling of queasiness before having blood in the stool, and after the stool, both eyes are black, panic, and even fainting. The patient has a pale face, thirst, rapid and weak pulse, and a drop in blood pressure. Regular epigastric pain mostly occurs in patients with ulcer disease, and the pain can be relieved by alkaline drugs.X-ray barium meal examination is of great significance in the diagnosis of ulcer disease. In addition to palpable mass, patients with gastric cancer also have obvious loss of appetite, epigastric discomfort, dyspepsia and lethargy, and the condition develops rapidly. barium X-ray and gastroscopy can help to confirm the diagnosis. Drug-induced acute ulcers or trauma-induced stress ulcers, most of them have a history of long-term use of aspirin, cortisone and other drugs, or have recently undergone major surgery, serious burns and other circumstances.
The majority of patients with acute gastric hemorrhage can be treated with non-surgical methods. Specific measures include blood transfusion, fluid transfusion, and the use of various types of hemostatic drugs through different routes. Surgery can be considered for bleeding caused by gastric cancer and gastric bleeding that cannot be controlled by the above treatments.
Stomach bleeding is a common complication of ulcer disease. Generally speaking, when stomach bleeding occurs, as long as there is no blood vomiting, you can eat. However, patients who vomit blood must be fasted to prevent choking from food vomiting or blood vomiting. Usually, 12 hours after the vomiting of blood has ceased, eating can be considered to be resumed, regardless of whether there is still black stool or not. If there is vomiting of blood again, then fasting again.
Hemorrhagic gastritis, once diagnosed, must be hospitalized in a timely manner to prevent patients from massive bleeding, resulting in life-threatening. The principle of treatment is to remove all kinds of triggering factors, reduce the acidity of the stomach to prevent hydrogen ion back diffusion and aggravate the damage of the gastric mucosa, active hemostasis, blood transfusion and rehydration. Specific measures are as follows:
(1) replenish blood volume: give a drop of whole blood or fresh frozen plasma, plasma substitute and balanced saline solution, etc., and improve microcirculation if there is shock.
(2) Ice saline gastric lavage: it can make the gastric wall vasoconstriction, and make the gastric acid secretion decrease, and promote hemostasis. The method is to leave the gastric tube in the stomach, first pump out the gastric juice, inject 200-300 ml of ice saline, and then pump out, repeated rinsing 3-4 times, and finally add norepinephrine 4 mg into 250 ml of ice saline, injected into the stomach, in order to further vasoconstriction. it can be repeated 1 time after 4 hours.
(3) Application of H2 receptor antagonists: H2 receptor antagonists such as mexiletine, ranitidine, famotidine have strong inhibition of gastric acid secretion and reduce the hydrogen ion concentration. In general, metformin 0.2 grams, once in 6 hours; or ranitidine 150 mg, once in 12 hours, orally; in critical condition, metformin 0.4 grams or ranitidine 300 mg can be used IV.
(4) antacid: hourly oral aluminum thioglycollate 0.75 grams or a mixture of aluminum hydroxide and magnesium hydroxide, can neutralize gastric acid to protect the gastric mucosa.
(5) Electrocoagulation or laser hemostasis by fiberoptic gastroscopy is reliable. Due to the conditions, it is still difficult to popularize.
(6) Selective arteriography with drops of posterior pituitary hormone to constrict the bleeding vessels to achieve the purpose of hemostasis. The current clinical application is less.
(7) Surgical treatment: the vast majority of patients can stop bleeding after medical treatment, but there are still about 10% of patients need surgery, otherwise it is difficult to control bleeding. Surgery is usually performed by vagotomy and subtotal gastrectomy.
The question of what to eat after gastric hemorrhage is generally governed by the following principles: start eating fluids, rice soup, lotus root powder is better, and milk should be consumed in moderation. Do not drink too acidic and too sweet food, these are to increase the production of acid. Small and frequent meals, warm diet, too hot food may make the gastric mucosa blood vessel dilation, is not conducive to hemostasis. Strong tea and coffee should be avoided. If the food is light and tasteless, adding a little salt is harmless. After the bleeding stops, you can gradually increase the variety and quantity of food.
Treatment for mild cases and after control: imported omeprazole and aluminum hydroxide gel for acid control, Yunnan Baiyao capsule for hemostatic medicine, bismuth such as Rezulodex available for sterilization and protection of gastric mucosa, and New Weilaxin capsule available
.