Diagnosis of a gastric bleeding
In many cases, gastric bleeding is diagnosed only at the hospital.This is because the patient usually cannot interpret the symptoms such as tarry stools. Often either the drop in performance (in the case of seeping stomach bleeding) or in acute cases the vomiting of blood (in the case of heavy bleeding) leads him to the doctor. With the help of a stool test (haemoccult test), the doctor can see whether there are any tiny blood particles in the patient’s stool.
Furthermore, it would have to be asked whether there had already been a previous history of gastric bleeding or a stomach ulcer. Furthermore, the patient should be asked whether he or she has been taking anti-inflammatory drugs such as diclofenac or ibuprofen for a long time. If there is a suspicion of gastric bleeding, a blood count must be taken to determine whether and, if so, how much blood has been lost (Hb drop).
In addition, a gastroscopy should be performed as soon as possible. During this procedure, the patient is given a short sleeping syringe and a tube with a camera is inserted through the oesophagus into the stomach. During this procedure, the stomach is inspected and corresponding sources of bleeding are shown. In unclear cases an MRI according to Sellink can be performed if necessary. In this case, oral contrast medium is administered prior to the MRI examination in order to visualize the small intestinal mucosa in particular.
Classification
Gastric bleeding is divided into several forms named after Forest. At
- Forest 1a it concerns an acute, injecting bleeding, with
- Forest 1b around an acute oozing bleeding. At
- Forest 2a a vessel stump is visible, in
- Forest 2b a stomach ulcer with coagulated blood and with
- Forest 2c older blood deposits. At
- Forest 3 there is no bleeding, but one or more suspicious erosion on the stomach wall.
