Synonym
gastrointestinal bleeding A gastric bleeding is a source of bleeding in the area of the stomach caused by various basic diseases with corresponding symptoms and sometimes life-threatening consequences, which makes it necessary to take the fastest possible action and make a diagnosis.
Causes/forms
In more than half of the cases, the cause of gastric bleeding is a gastric ulcer (ulcus duodeni, ventrikuli), which has been developing unnoticed in the stomach wall for a long time and eventually leads to bleeding. In about 50% of cases, patients with a gastric bleeding have one or more such ulcers. Somewhat less frequently (15%) gastric bleeding is caused by gastric migration erosions.
In most cases, this form of wall erosion is due to the fact that too little gastric mucosa has been built up, but the gastric acid comes into unhindered contact with the unprotected stomach wall. This attacks the stomach wall and can lead to bleeding. In most cases, reduced mucosal production is due to the chronic intake of anti-inflammatory drugs (NSAID).
In about 1-5% of cases of gastric bleeding, the cause is a malignant tumor development in the stomach (gastric carcinoma). In rare cases, benign tumors can also cause gastric bleeding. In addition, severe courses of gastritis (chronic gastritis) can lead to gastric bleeding.
Chronic and intensive alcohol consumption with strong alcoholic beverages can cause such chronic gastritis. Relatively rarely, gastric bleeding occurs due to vascular malformations in the area of the stomach wall (so-called angiodysplasias). These are already present at birth and cause no discomfort.
They are characterized by either the angiodysplasias open by themselves due to the strong pressure or angular, badly chewed food remains lead to a mechanical injury of the vessel. In about 5 % of the cases no cause of the gastric bleeding can be found, which in most cases then comes to a halt again.
- Strongly tortuous vascular anatomies with
- Filled lumen of the vessel and corresponding
- High blood pressure in the vessels.
Stress per se does not usually cause stomach bleeding.
It is known, however, that stress can lead to an increased incidence of stomach diseases, such as gastric ulcers (ulcera ventriculi or duodeni) and inflammation of the esophagus. In both diseases, the risk of bleeding in the stomach is increased. Peptic ulcers in particular can bleed profusely and thus result in dangerous blood loss.
Symptoms that indicate a peptic ulcer include pressure or pain in the upper abdomen, nausea and loss of appetite. Patients suffering from peptic ulcer or inflammation of the esophagus are usually started on medication with an acid inhibitor (for example proton pump inhibitor such as pantozole). This makes the stomach secretion less acidic and the ulcer inflammation can heal better.
Alcohol also does not lead directly to gastric bleeding. However, it seems to have been proven that frequent consumption of (high-proof) alcohol leads to more frequent inflammation of the esophageal mucosa and superficial damage to the stomach lining. As a result of this damage to the mucous membrane, the probability of the occurrence of gastric ulcers is increased.
Such a peptic ulcer, in turn, can often bleed, which in some cases can lead to marked blood loss with an urgent need for clinical treatment. Quite a few medications are known to significantly increase the risk of the occurrence of gastric ulcers. If such an ulcer is present, there is a risk that it will start to bleed.
Sometimes this leads to a life-threatening loss of blood. In particular, medicines from the group of non-steroidal anti-inflammatory drugs (NSAIDs), which are taken as pain and inflammation inhibiting drugs, significantly increase the risk of developing a stomach ulcer when taken over a longer period of time. These painkillers include ibuprofen and diclofenac.
If these drugs are additionally combined with a cortisone preparation, the risk of developing a peptic ulcer increases 16-fold compared to the normal population. Therefore, it is important that patients who regularly take medication from these groups take prophylactic therapy to protect their stomachs. Drugs that are also used to treat existing stomach ulcers or mucous membrane inflammation (e.g. proton pump inhibitors) are suitable for this purpose.They reduce the acid production in the stomach and therefore inhibit the progression of the inflammatory reaction.
These drugs include pantozole and omeprazole. Patients taking regular medication such as ibuprofen should take one such acid-inhibiting tablet once a day. This significantly reduces the risk of developing a stomach ulcer – and thus the risk of stomach bleeding.
Local application of diclofenac (for example as Voltaren ointment) or ibuprofen does not increase the risk of developing a stomach ulcer. 1 Ibuprofen Ibuprofen is a drug that has an analgesic and anti-inflammatory effect and belongs to the group of non-steroidal anti-inflammatory drugs. It is a popular pain medication, as are other members of this group of active ingredients.
However, when taken regularly, there is an increased risk of developing a stomach or duodenal ulcer. Therefore, if ibuoprofen has to be taken regularly, an additional tablet should be taken to protect the stomach. A drug from the group of acid inhibitors, such as pantozole, is suitable here.
If taken daily, the risk of developing an ulcer is significantly reduced under long-term ibuprofen therapy. 2 Diclofenac Diclofenac is also a drug from the group of non-steroidal anti-inflammatory drugs and is used as an analgesic and anti-inflammatory. Like ibuprofen, diclofenac, if taken regularly, increases the risk of developing ulcers in the stomach and duodenum.
Regular use of this analgesic should therefore be combined with pantozole, an acid inhibitor, which protects the stomach lining and counteracts the development of a gastric ulcer as effectively as possible. 3 Aspirin Also aspirin, a popular painkiller that also has anti-inflammatory properties, increases the likelihood of developing a stomach ulcer and thus the risk of developing gastric bleeding if taken regularly, as do ibuprofen and diclofenac. In this respect, if aspirin is taken regularly, the daily intake of a stomach protection tablet, e.g. Pantozol, should be taken.
