Thepatient, an 89-year-old female, is presented to the EmergencyDepartment (ED) and has a right foot pain, dark stool, fresh blood,and fecal impaction. The patient is a former dental hygienist. Shedoes light activities, but stills ambulate with no assistingequipment. Friends shop for her. Her stool is black in color and haspatches of fresh blood. This is worrying. Additionally, the patientis complaining of experiencing a tingly feeling in her legs, andnumbness. She has fallen several times in the last six months, andinjured her right leg severely in her last fall, two days ago. Eventhough the patient does not feel pain, she had bruises on her legs.
Gastrointestinalbleeding, known as , is caused by diverticular hemorrhage.Indeed, diverticular hemorrhage is the leading cause of thisdisorder. Another primary cause of gastrointestinal bleeding ispeptic ulcer disease. However, the knowledge about Helicobacterpylori, and more information on gastric acid destruction in thehandling of peptic ulcer hemorrhage, and the expansion of endoscopichemostatic techniques have all combined to reduce chances ofoccurrence of peptic ulcer disease (Yachimski& Friedma, 2013). There are other common causes of such as esophageal or gastric varices, esophagitis or esophagealulcer, Mallory–Weiss tear, gastropathy, and less common causes suchas portal hypertensive gastropathy, and Hemobilia, to mention just afew.
GIbleeding is a disease that mostly affects the elderly individuals.The most susceptible ones are those who are above the age of eighty.In 2012, the Centers for Disease Control and Prevention gave a reportthat indicated that than 1% of those who are aged 80 years, and aboveundergo treatment for gastrointestinal bleeding, which is thedominant cause of . However, the morbidity and mortalityrate in the senior citizens, morbidity, and mortality from GIbleeding in this age group is influenced by the extent of bleedinglesion and the presence of comorbid medical conditions (NationalInstitutes of Health (U.S.). 2011). Additionally, the use ofantiplatelet or anticoagulant agents and aspirin also play a part inthe cause of gastrointestinal bleeding in elderly persons.
Simplyput, gastrointestinal bleeding is a disease that gives an indicationof a disorder of the digestive tract of the affected person. Thebleeding, which typically comes in the form of a vomit or stool, isnot always easy to notice. This bleeding originates from the GItract, either the upper or the lower tract (National Institutes ofHealth (U.S.). 2011). Thus, if the bleeding comes from the lowertract, then the disease is known as lower gastrointestinal bleeding.However, when the disease emerges from the upper tract, then theinfection is called the upper gastrointestinal bleeding.
Themost obvious manifestation of gastrointestinal (GI) bleeding is bloodin the stool and vomit. The long tract that constitutes thegastrointestinal (GI) consists of organs like esophagus, stomach,small intestine, large intestine (colon), rectum, and all the way tothe anus(Yachimski& Friedma, 2013).Theperson suffering from gastrointestinal (GI) bleeding also mayexperience will feel abdominal pain, weakness, pale skin, andfatigue, and shortness of breath.
Medicaland Surgical Management
Medically,the disease can be managed by proper monitoring of the medicalregimen prescribed to a patient. During this time, in the hospital,the patient should be encouraged to engage in activities such ascombing hair, self-feeding, bathing, and brushing teeth. Thepatient`s bed should be in the lowest position, with its wheelslocked, and side rails straightened up to avoid any chances offalling (Greenberger, 2015). The telephone should be close enough tomake sure that the patient can reach it with ease.
Beforethe Gastrointestinal bleeding diagnosis, the patient had beendiagnosed with Hypertension, Atrial Fibrillation, hyperlipidemia,weakness of right leg and Peripheral Neuropathy, which happened in2015, Uterine Cancer (2010), CHF (congestive heart failure) (2000)and endometrial adenocarcinoma (Sung et al., 2012).
Thepatient’s results came back with a Normal Lab Values for CBC.Additionally, in the HGB7.9 test, the patient registered low levelsof 12-16. Even though the gastrointestinal bleeding is common amongthe old, most of the patients recover from the disease. Given thecircumstances surrounding this patient, she is highly likely torecover from the illness too. During my shift, I did not note acutecomplaints from the patient.
Greenberger,N. (2015). Currentdiagnosis and treatment – gastroenterology, hepatology, andendoscopy.Mcgraw-hill medical Publishing division.
NationalInstitutes of Health (U.S.). (2011). Endoscopyin upper .Bethesda, Md.: National Institutes of Health?.
Sung,J. J. Y., Kuipers, E., & Barkun, A. (2012). GastrointestinalBleeding.Hoboken: John Wiley & Sons.
Yachimski,P.S. & Friedma, L.S. (2013). Gastrointestinal bleeding in theelderly. Nature. Retrieved from:http://www.nature.com/nrgastro/journal/v5/n2/full/ncpgasthep1034.html