GI bleeds

Question 1

Cause of upper GI bleeds?

Answer 1

• Oesophageal: neoplasia, Mallory-weiss, varices, oesophagitis
• Stomach: peptic ulcer, gastritis, neoplasia
• Duodenum: perforated DU, neoplasia
• Jejunum: neoplasia

Question 2

Causes of lower GI bleeds?

Answer 2

• Ilem/caecum: Meckel’s, obstruction, neoplasia
  
  • Meckel’s = within the ileum, ectopic gastric tissue, 2 feet from IC valve
• Large intestine: colorectal cancer, UC, angiodysplasia, infectious colitis (shigella, salmonella), diverticulosis, post polypectomy
• Ischaemic bowel
  
  • Rapid AF, thromboembolic events
• Rectal/anal: haemorrhoids, fissures, rectal neoplasia, varices, UC, polyps
  
  • If you examine a patient and they have haemorrhoids and PR bleeding you still have to investigate all of the other causes – colonoscopy