How to deal with intestinal bleeding?

Although the intestine is a relatively large organ in the human body, due to its thin intestinal walls and the lack of protection from skin tissue, the intestine is easily irritated by foreign bodies or even viral infections. The most common symptom is intestinal bleeding. This phenomenon must be treated as soon as possible, otherwise it is very easy to cause heavy bleeding and endanger life. Let’s take a look at how to deal with intestinal bleeding?

(1) Symptomatic treatment of chronic, small-volume bleeding mainly targets the primary disease (cause). In case of acute massive bleeding, the patient should rest in bed and fast; closely observe changes in the condition, maintain intravenous access and measure central venous pressure. Keep the patient's airway open to avoid suffocation caused by vomiting blood. And take appropriate treatment for the primary disease.

(2) Replenishing blood volume In case of acute massive bleeding, intravenous infusion should be given rapidly to maintain blood volume and prevent a drop in blood pressure . When hemoglobin is lower than 6 g/dl and systolic blood pressure is lower than 12 kPa (90 mmHg), blood transfusion should be considered. Avoid excessive blood transfusion or infusion to prevent acute pulmonary edema or re-bleeding.

(3) Endoscopic treatment has limited hemostatic effect under colonoscopy and small enteroscopy and is not suitable for acute massive bleeding, especially for diffuse intestinal lesions. Specific methods include: argon plasma coagulation (APC), electrocoagulation (including monopolar or multipolar electrocoagulation), cryostasis, thermal probe hemostasis, and spraying of epinephrine, thrombin, leptin and other drugs on the bleeding lesions to stop bleeding. APC, electrocoagulation and other hemostatic methods should not be used for bleeding caused by diverticulum to avoid intestinal perforation.

(4) Minimally invasive interventional treatment: After selective angiography shows the bleeding site, hemostasis treatment can be performed through the catheter. The goal of hemostasis can be achieved in most cases. Although some cases will bleed again during hospitalization, the patient's general condition has improved during this period, creating good conditions for elective surgical treatment. It is worth pointing out that gastrointestinal bleeding caused by intestinal ischemic diseases is contraindicated. Generally speaking, embolization is not recommended for hemostasis in cases of lower gastrointestinal bleeding after arterial catheterization because embolization of the proximal blood vessels can easily cause ischemic necrosis of the intestine, especially the colon.