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Recurrent or refractory bleeding may lead to need for surgery, although this has become uncommon as a result of improved endoscopic and medical treatment. Upper gastrointestinal bleeding affects around 50 to 150 people per 100,000 a year. It represents over 50% of cases of gastrointestinal bleeding. [2]
Patients with bleeding gastric varices can present with bloody vomiting (hematemesis), dark, tarry stools , or rectal bleeding. The bleeding may be brisk, and patients may soon develop shock . Treatment of gastric varices can include injection of the varices with cyanoacrylate glue, or a radiological procedure to decrease the pressure in the ...
Despite treatment, re-bleeding occurs in about 7–16% of those with upper GI bleeding. [3] In those with esophageal varices, bleeding occurs in about 5–15% a year and if they have bled once, there is a higher risk of further bleeding within six weeks. [13] Testing and treating H. pylori if found can prevent re-bleeding in those with peptic ...
Most patients do remain obese (BMI 25-35) following surgery despite significant weight loss, and patients with BMI over 40 tended to lose more weight than those with BMI under 40. [29] [30] Concerning metabolic syndrome, bariatric surgery patients were able to achieve remission 2.4 times as often as those who underwent nonsurgical treatment.
Bleeding in the stomach and intestines, edema, dilated blood vessels Gastric antral vascular ectasia ( GAVE ) is an uncommon cause of chronic gastrointestinal bleeding or iron deficiency anemia . [ 1 ] [ 2 ] The condition is associated with dilated small blood vessels in the gastric antrum , which is a distal part of the stomach . [ 1 ]
The gastric bypass reduces the size of the stomach by well over 90%. [4] A normal stomach can stretch, sometimes to over 1000 mL, while the pouch of the gastric bypass may be 15 mL in size. The gastric bypass pouch is usually formed from the part of the stomach that is least susceptible to stretching.
However, the lesions may be widespread, making such treatment impractical. [citation needed] If the bleeding is from multiple or inaccessible sites, systemic therapy with medication may be necessary. First-line options include the antifibrinolytics tranexamic acid or aminocaproic acid. Estrogens can be used to stop bleeding from angiodysplasia.
Portal hypertensive gastropathy can also be treated with endoscopic treatment delivered through a fibre-optic camera into the stomach. Argon plasma coagulation and electrocautery have both been used to stop bleeding from ectatic vessels, and to attempt to obliterate the vessels, but have limited utility if the disease is diffuse. [8] [10]