| Theme | Diagnoses & Treatments for Gastrointestinal Bleeding on the Basis of JGES Guidelines | |
|---|---|---|
| Title | Evaluation and Initial Treatment for Melena and Hematochezia -- Differentiation of the Two Types of Bleeding | |
| Publish Date | 2017/03 | |
| Author | Tomoki Fujita | Department of Gastroenterology, Otaru Ekisaikai Hospital |
| Author | Yuya Komatsu | Department of Gastroenterology, Otaru Ekisaikai Hospital |
| Author | Eriko Waga | Department of Gastroenterology, Otaru Ekisaikai Hospital |
| Author | Kunihiro Takanashi | Department of Gastroenterology, Otaru Ekisaikai Hospital |
| Author | Tomonori Ambo | Department of Gastroenterology, Otaru Ekisaikai Hospital |
| Author | Shinichi Katsuki | Department of Gastroenterology, Otaru Ekisaikai Hospital |
| [ Summary ] | Both melena and hematochezia are gastrointestinal bleeding, but their causes are different. Upper gastrointestinal bleeding is initially suspected as the cause of melena and lower gastrointestinal bleeding as that of hematochezia. The cause is predicted based on medical history, medication use, and symptoms such as abdominal pain and/or diarrhea. Since treatment and prognosis of variceal bleeding differ from those of non‒variceal bleeding, close attention to the findings is required, similar to liver cirrhosis. Subsequently, according to the vital signs we need to evaluate blood transfusion requirements and urgency of endoscopy. It is necessary to perform examination and treatment as soon as possible. When the bleeding point cannot be detected, it is classified as obscure gastrointestinal bleeding (OGIB) and small intestinal examination should be performed. |
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