High Doses Of Ibuprofen Cause Significant Gi Bleeding Despite Safety Profile
- Date:
- American Gastroenterological Association
- Summary:
- People who take high doses of ibuprofen on a regular basis are three times more likely to experience gastrointestinal bleeding than those who do not take painkillers. Results of a small, retrospective analysis published today in the American Gastroenterological Association journal Clinical Gastroenterology and Hepatology show that significant GI bleeding can be observed as early as three days after starting an ibuprofen regimen in otherwise healthy people.
People who take high doses of ibuprofen on a regular basis are three times more likely to experience gastrointestinal bleeding than those who do not take painkillers. Results of a small, retrospective analysis published today in the American Gastroenterological Association journal Clinical Gastroenterology and Hepatology show that significant GI bleeding can be observed as early as three days after starting an ibuprofen regimen in otherwise healthy people–giving credence to the belief that high doses of non-steroidal anti-inflammatory drugs , no matter the safety profile, are likely to cause gastrointestinal bleeding that can be harmful to the digestive system.
The authors of this study are hopeful that these findings will bring attention to the reality of the amount of painkillers potentially being used by patients at home and the fact that ibuprofen is often combined with other painkillers–potentially causing a greater amount of bleeding from the GI tract.
How Is Bleeding In The Digestive Tract Diagnosed
The site of the bleeding must be located. A complete history and physical examination are essential. Symptoms such as changes in bowel habits, stool color and consistency, and the presence of pain or tenderness may tell the doctor which area of the GI tract is affected. Because the intake of iron or foods such as beets can give the stool the same appearance as bleeding from the digestive tract, a doctor must test the stool for blood before offering a diagnosis. A blood count will indicate whether the patient is anemic and also will give an idea of the extent of the bleeding and how chronic it may be.EndoscopyEndoscopy is a common diagnostic technique that allows direct viewing of the bleeding site. Because the endoscope can detect lesions and confirm the presence or absence of bleeding, doctors often choose this method to diagnose patients with acute bleeding. In many cases, the doctor can use the endoscope to treat the cause of bleeding as well.
The endoscope is a flexible instrument that can be inserted through the mouth or rectum. The instrument allows the doctor to see into the esophagus, stomach, duodenum , colon , and rectum to collect small samples of tissue to take photographs and to stop the bleeding.
Small bowel endoscopy, or enteroscopy, is a new procedure using a long endoscope. This endoscope may be introduced during surgery to localize a source of bleeding in the small intestine.
How Do Doctors Determine The Cause Of Bleeding
Diagnosis of the underlying cause of your GI bleeding will usually start with your doctor asking about your symptoms and medical history. Your doctor may also request a stool sample to check for the presence of blood along with other tests to check for signs of anemia.
Upper GI bleeding is most commonly diagnosed after your doctor performs an endoscopic examination.
Endoscopy is a procedure that involves the use of a small camera located atop a long, flexible endoscopic tube your doctor places down your throat. The scope is then passed through your upper GI tract.
The camera allows your doctor to see inside your GI tract and potentially locate the source of your bleeding.
Because endoscopy is limited to the upper GI tract, your doctor may perform an enteroscopy. This procedure is performed if the cause of your bleeding isnt found during an endoscopy.
An enteroscopic exam is similar to an endoscopy, except theres usually a balloon attached to the camera-tipped tube. When inflated, this balloon allows your doctor to open up the intestine and see inside.
To determine the cause of lower GI bleeding, your doctor may perform a colonoscopy. During this test, your doctor will insert a small, flexible tube into your rectum. A camera is attached to the tube so your doctor can view the entire length of your colon.
Air moves through the tube to provide a better view. Your doctor may take a biopsy for additional testing.
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What Causes Stomach Pains And Rectal Bleeding
Few things generate more worry than an episode of rectal bleeding. For most people, the sight of blood in their stool triggers fears of life-threatening problems. If your bleeding is associated with abdominal pain, your concerns may intensify. The location of your discomfort could offer some clues about the cause of your bleeding. But the source of abdominal pain is often difficult to identify, even for doctors. While most gastrointestinal bleeding stems from hemorrhoids or other noncancerous conditions, rectal bleeding and abdominal pain are a worrisome combination and you should see your doctor for an evaluation.
What Are The Complications And Prognosis For Gastrointestinal Bleeding
The outcome of treatment for gastrointestinal bleeding greatly depends on several factors including:
- The cause and location of the bleeding
- The rate of bleeding when the person sees a doctor
- Prior health problems and conditions
- Maintain a proper diet and take the medications prescribed as directed.
Follow-up with your doctor on a regular basis to monitor progress, so that the doctor can prevent further progression and complications of gastrointestinal bleeding.
Sometimes, the complications of gastrointestinal bleeding can be fatal.
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Internal Bleeding In Your Head
This can cause:
- overall weakness
The presence of other underlying conditions may help doctors identify if youre losing blood somewhere.
For example,anemia is commonly associated with a slow and chronic internal bleeding. It can cause fatigue, weakness, and shortness of breath.
Some people with internal bleeding will also have low blood pressure because of the constant blood loss. This is known as orthostatic hypotension. Common symptoms include feeling dizzy or light-headed when you stand.
Does Everyone Experience Gastrointestinal Bleeding Differently
It is important to know that bleeding in the digestive system is commonly divided into two designations: Upper & Lower GI bleeding.
Upper GI bleeding is everything from the oesophagus to the start of the small intestine .
Lower GI bleeding is everything from the small intestine to the rectum.
There can be subtle differences in how bleeding occurs within the upper and lower bands. Ulcers, for example, tend to be more common in upper GI bleeding while polyps are more frequent in the lower.
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Causes Of Upper Gi Bleeding
Peptic ulcers are a common cause of GI bleeding. These ulcers are open sores that develop in the lining of your stomach or duodenum. An infection from H. pyloribacteria usually causes peptic ulcers.
Also, enlarged veins in your esophagus can tear and bleed as a result of a condition called esophageal varices. Tears in the walls of your esophagus can also cause GI bleeding. This condition is known as Mallory-Weiss syndrome.
What Are The Signs And Symptoms Of Gi Bleeding
Symptoms depend on where the bleeding is, what is causing it, and how much blood you have lost. You may have any of the following:
- Blood in your vomit, or vomit that looks like coffee grounds
- Dark or bright red blood in your bowel movements
- Bleeding from your rectum
- Urinating less than usual or not at all
- Fainting or loss of consciousness
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Why Am I Experiencing Vaginal Bleeding After Menopause
Vaginal bleeding after menopause may be due to medications, hyperplasia of the uterus, or some types of uterine cancer. Certain medications containing estrogen or progesterone can cause either hyperplasia or an increase in the amount of tissue in the uterus, which may cause bleeding or an excess sloughing off of tissue both of which will be seen as vaginal bleeding.
Common Causes Of Pediatric Gi Bleeding Plus Treatment Information
Parenting is a journey during which you encounter things you weren’t prepared for, especially when your child is sick. One of the scariest situations for parents is when a child has blood in their stool or vomit, which is known as gastrointestinal bleeding.
About six in 100 pediatric gastroenterology patients experience GI bleeding, and the causes can range from generally harmless situations such as swallowing blood after a nosebleed to more serious conditions such as ulcers in the GI tract.
Signs include traces of blood in the stool, appearing pale, and vomiting blood, which can be bright red or look like coffee grounds. Left untreated, GI bleeding can lead to shock, anemia, and even death in the most severe cases.
Quick diagnosis is key, so the UT Southwestern and Children’s Health pediatric gastroenterology team are creating a new, collaborative database with other medical centers to improve the accuracy of diagnosis and help more kids feel better faster.
The first step is to talk with your child and their doctor about symptoms to pinpoint where the bleeding started and why.
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Why Does Gi Bleeding Occur
- In upper GI bleeding, stomach acid or bacterial/viral toxin can irritate the esophageal lining to the point of bleeding.
- Severe retching may cause tears in the lining of the upper GI tract causing blood in vomitus.
- Portal hypertension due to liver failure or splenic vein thrombosis may cause bleeding in the esophageal vascular system or rectal blood vessels.
- In lower GI bleeding, straining and passing hard or wide stools can injure the rectal lining and cause bleeding.
- Polyps are finger-like overgrowths of the lining of the intestine that may bleed when the stools rub against them.
- Diverticulosis is a condition where pouches develop in the lining of the intestine and bleed due to trauma.
- Any type of cancerous mass anywhere in the GI system may rupture, causing bleeding.
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How To Prevent Gastrointestinal Bleeding
The prognosis for a person with GI bleeding depends upon the cause and location of the bleeding, how bad the bleed is when the person sees the doctor, and any underlying medical conditions that may affect the patients recovery.
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Alcohol & Upper GI Bleeding
For those that consume alcohol, do so in moderation. Patients with high alcohol consumption are widely at risk for gastrointestinal bleeding within the upper digestive tract, which can result in death. Alcohol also accelerates the development of gastritis, which is an inflammation of the stomach lining. Over time, the inflammation can lead to erosion of the stomach lining, which plays a vital role in regulating stomach acid.
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NSAIDs Increase The Risk Of Lower GI Bleeding
Non-steroidal anti-inflammatory drugs, or NSAIDS, are drugs that intend to reduce pain and fever, prevent blood clots, and reduce inflammation. They can also cause gastrointestinal bleeding, so it would be best to take these medications as rarely as possible. Examples of NSAIDs include ibuprofen, Advil, Motrin, aspirin, Celebrex, and Naproxin.
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Can Smoking Cause Gastrointestinal Bleeding?
The risk of developing gastrointestinal bleeding increases significantly in individuals that smoke. Smoking not only causes peptic ulcers and other severe medical conditions, but it also can slow down the healing process for peptic ulcers. Furthermore, smoking interferes with ulcer medication, making the treatment less effective.
What You Can Do
When you make the appointment, ask if there’s anything you need to do in advance, such as fasting before a specific test. Make a list of:
- Your symptoms, including any that seem unrelated to the reason for your appointment and when they began
- All medications, vitamins or other supplements you take, including doses
- History of digestive disease you’ve been diagnosed with, such as GERD, peptic ulcers or IBD
- Questions to ask your doctor
Take a family member or friend along, if possible, to help you remember the information you’re given.
For gastrointestinal bleeding, basic questions to ask your doctor include:
- I’m not seeing blood, so why do you suspect a GI bleed?
- What’s likely causing my symptoms?
- Other than the most likely cause, what are other possible causes for my symptoms?
- What tests do I need?
- Is my condition likely temporary or chronic?
- What’s the best course of action?
- What are the alternatives to the primary approach you’re suggesting?
- I have other health conditions. How can I best manage them while my bleeding is treated?
- Are there restrictions I need to follow?
- Should I see a specialist?
- Are there brochures or other printed material I can have? What websites do you recommend?
Don’t hesitate to ask other questions.
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Pancreatic Cancer And Puking Blood
Sometimes, you may throw up blood due to pancreatic cancer. Pancreatic cancer begins in the tissues of your pancreas, an organ in the abdomen that lies horizontally behind the lower part of the stomach. Pancreas releases enzymes that help in digestion and hormones that help control blood sugar levels.
Nausea and vomiting occurs particularly during later stages of the pancreatic cancer, when the tumor has grown significantly large enough to block at least a part of the digestive tract .
Can Stress Cause Vaginal Bleeding
No, stress cannot cause vaginal bleeding. Stress can, however, cause an earlier or later menstrual cycle and cause bleeding in-line with a new cycle. If you have new mid-cycle bleeding and have not consulted a clinician, you should seek medical evaluation. It may be a sign of anything from a sexually transmitted infection , to fibroids, to a pregnancy, or it may have no definable cause.
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Vomiting Blood As A Sign Of Esophageal Cancer
Vomiting blood is not the main symptoms of esophageal cancer, but it eventually affects patients suffering from this type of cancer. Usually, patients experience problems such as difficulty in swallowing, which is a common sign of the tumor or cancer in esophagus. Vomiting blood only occurs if the cancer grows rapidly. The growth of esophageal cancer is not accompanied by sufficient growth of the blood vessels that supply nutrients to the tumor. Some parts of the tumor may become necrotic and start bleeding. Bleeding of the esophageal cancer is also possible during radiation therapy of the cancer.
Bleeding from the esophagus in patients with esophageal cancer is not a good sign and may indicate to progression of the disease. People who have developed an esophagotracheal fistula may have more esophageal bleeding.
What To Expect From Your Doctor
Your doctor is likely to ask you questions, such as:
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Do you take non-steroidal anti-inflammatory medication, either over-the âcounter or prescribed, or do you take aspirin?
- Do you drink alcohol?
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Common Causes Of Pediatric Gi Bleeding
Based on the child’s symptoms, a physical exam, and additional information from the parent, we often can diagnose the underlying issue without much additional testing. For example, well ask about:
- Bowel habits
- Food aversions
- Symptom frequency
- What makes them feel better
The information we gather typically points to one of seven common conditions that can cause GI bleeding in children.
Treatment Of Gastrointestinal Bleeding
Treatment for gastrointestinal bleeding varies depending on the condition and the lifestyle of the patient. Patients who smoke or drink should quit their habits to allow the bleeding to subside. If damaging elements are removed, the bleeding can go away on its own. However, if the bleeding continues over time and the habits do not change, it can become chronic. It may not stop and worsen over time.
Doctors may also recommend an endoscopy. The procedure involves the use of an endoscope, which is a unique scope equipped with a small camera and a laser that goes down the throat. The device tunnels through the digestive tract and pinpoints the bleeding, and the laser attachment can help stop the bleeding. Antibiotics may also help inflammation.
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Vomiting Blood As A Sign Of Colon Cancer Or Colorectal Cancer
Many cases of colorectal cancer have no symptoms or warning signs until the cancer has advanced. Vomiting can be one of these signs. However, it is important to note that vomiting can be caused by a number of other normal problems such motion sickness, unpleasant sights or smells.
If nausea and vomiting are accompanied with other symptoms such as constipation or pain, colon cancer could be the cause. When vomiting is a symptom of colon cancer, it is usually because a tumor is causing a bowel obstruction. Vomiting may be accompanied with blood depending on the severity of the blockage. With colon cancer, some patients throw up blood quite frequently. But it is usually accompanied with other conditions such as abdominal pain, changed bowel movements, constipation, etc.