| Theme |
Diseases of Alimentary Tract in Maintenance Dialysis Patients |
| Title |
Upper gastrointestinal bleeding in hemodialysis patients |
| Author |
Hiroshi Takakuwa |
Department of Internal Medicine, Kanazawa Municipal Hospital |
| Author |
Manabu Yoneshima |
Department of Internal Medicine, Kanazawa Municipal Hospital |
| Author |
Toshio Abe |
Department of Internal Medicine, Kanazawa Municipal Hospital |
| [ Summary ] |
Symptoms, diagnosis of and treatment for upper gastrointestinal bleeding in hemodialysis patients. Patients receiving anticoagulant during hemodialysis could present with an ulcer-related complication, especially upper gastrointestinal hemorrhage in NSAIDs users for treatment of other conditions, without antecedent symptoms. It is necessary to perform emergency endoscopic examinations and hemostatic procedures when upper gastrointestinal bleeding occurres. According to the guidelines for the treatment of gastric ulcers, we should provide treatment for anemia and shock, and perform endoscopic examinations, along with hemostatic procedures. We should begin ulcer therapy with proton pump inhibitors, administered intravenously when necessary. If medical procedures can not stop gastrointestinal bleeding, patients will require surgical procedures. On the other hand, we must recognize gastric antral vascular ectasia (GAVE) as an unique cause of upper gastrointestinal bleeding and a factor in the progression of anemic conditions. |