It is gastrointestinal bleeding in the upper gastrointestinal tract, commonly defined as bleeding arising from the oesophagus, stomach, or duodenum. Blood is often observed in vomit (hematemesis) or in the stool (melena). Upper gastrointestinal bleeding denotes a medical emergency and typically requires hospital care for primary diagnosis and treatment. The incidence of upper gastrointestinal bleeding is 50-150 individuals per 100,000 annually. Depending on its severity, it carries an estimated mortality risk of 11%.

The causes of upper gastrointestinal bleeding are as follows:

Oesophagal causes (gastrorrhagia):

Oesophagal varices
Esophagitis
Oesophagal cancer
Oesophagal ulcers
Mallory-Weiss tear
Gastric causes: 

Gastric ulcer
Gastric cancer
Gastritis
Gastric varices
Gastric antral vascular ectasia
Dieulafoy's lesions

Duodenal causes
Duodenal ulcer
Vascular malformation, including aorto-enteric fistulae
Hematobilia or bleeding from the biliary tree
Hemosuccus pancreaticus or bleeding from the pancreatic duct
Severe superior mesenteric artery syndrome
The signs and symptoms of upper gastrointestinal bleeding are as follows:

Hematemesis - Vomiting of blood
Melena - Blood in the stool
Hematochezia - Passage of fresh blood through the anus, usually in or with stools
Syncope - Loss of consciousness (fainting)
Presyncope - State of lightheadedness, muscular weakness, blurred vision, and feeling faint
Dyspepsia   IndigestionEpigastric painHeartburnDiffuse abdominal pain
Dysphagia - Difficulty in swallowing. Weight lossJaundice - Yellow discolouration of the skin, mucous membranes, and sclera
The diagnosis of upper gastrointestinal bleeding is made when hematemesis is present. In the absence of hematemesis, an upper source of GI bleeding is likely in the presence of at least two factors among - Black stool, age < 50 years or blood urea nitrogen/creatinine ratio 30 or more

If these findings are absent, consider a nasogastric aspirate to determine the source of bleeding. If the aspirate is positive, an upper GI bleed is greater than 50%, but not high enough to be certain. If the aspirate is negative, the source of a GI bleed is likely lower. The accuracy of the aspirate is improved by using the Gastroccult test. Also, the following diagnostic tests are done:

Orthostatic blood pressure
Complete blood count with differential counts
Hemoglobin level
Type and crossmatch blood
Basic metabolic profile, BUN,
Coagulation profile
Serum calcium
Serum gastrin
Endoscopy
Chest radiography
Nasogastric lavageAngiography (if bleeding persists and endoscopy fails to identify a bleeding site)
Upper gastrointestinal bleeding can be managed in the following ways:

Airway management and fluid resuscitation using either intravenous fluids and or blood
Medications to stop the bleeding (Proton-pump inhibitors are often given in the emergency)
Surgical intervention
Treating the consequences (like anaemia) that the bleeding may have caused
Precautions are taken to prevent re-bleeding

What Are The Reasons Behind Ulcer?

Do you know not all foods can be consumed on an empty stomach? So, it is imperative that you should be aware of such foods and restructure your breakfast menu accordingly. Here is a list of foods to avoid on an empty stomach. 

Stay away from the following foods when you eat after a considerable gap

Citrus fruits: Citrus fruits contain fruit acids. When these acids enter an empty stomach, they can lead to heartburn. Hence, if eaten after a prolonged period post meal, a person is at risk of gastritis and stomach ulcers.
Soda: Consuming cold soda drinks on an empty stomach may cause damage to the mucosal membrane while reducing blood flow to the stomach. This may lead to a slow digestive process and difficulty in the abdomen.
Spicy foods: Spicy foods are known to cause irritation and damage to the digestive tract, and are especially not recommended for people who suffer from acid reflux issues since very spicy food leads to consequences such as acid reflux in the food pipe.
Cucumber and other green vegetables: Green vegetables and cucumber are rich in amino acids. If consumed on an empty stomach it may very well lead to pain and bitterness in the upper abdomen.
Tomato: Tomato is a fruit containing high levels of tannin. Tannin causes acidity in an empty stomach and leads to consequences and appearance of gastritis if frequently consumed in such a manner.
Fermented milk products: Fermented milk products such as yogurt typically come with loads of health benefits being full of probiotics. But if consumed on an empty stomach it can interfere with the balance of healthy bacteria as the hydrochloric acid produced tends to be destructive.
Sweets: Items such as candy or sweetmeats contain high levels of sugar and cause a sudden and sharp surge of insulin levels in the blood. Over a long period, this has a bad effect on the pancreas.
Products containing yeast: Edible items such as biscuits, puff pastry, vinegar and beverages such as beer and wine contain yeast which can significantly irritate the stomach and cause bloating.
So, be a little conscious and avoid consuming these items on an empty stomach since a little effort goes a long way. In case you have a concern or query you can always consult an expert & get answers to your questions!

Empty Stomach - 8 Food Types That You Must Avoid!

Living with ulcerative colitis can be very challenging. Patients of this disease will have to deal with pain in the abdomen and several digestion related issues in their daily lives. It is known to adversely impact the digestive tract. There can be extreme discomfort at the time of flare-ups. A patient can find life extremely difficult while dealing with symptoms like abdominal pain, fever, weight loss, and chronic diarrhea.

What is Ulcerative colitis (UC)?
It is a serious inflammatory disease. It is caused due to inflammatory bowel movements in the digestive tract. It can affect your daily life adversely. The worst part about this disease is that it relapses in the individual. It is characterized by flare-ups. You need to know fist what is an UC flare-up. Well, it is a term to refer to an exaggerated condition in the disease. It refers to a state when things turn worse. These flare-ups can be caused due to a number of factors. Some of these include:

Side-effect of certain medicines
Hormonal imbalance, especially during pregnancy
Sudden withdrawal from medication
Any infection or other medical condition
How to deal with the UC flare-ups?

Doctors often prescribe corticosteroids to deal with the flare-ups. Some of the most common drugs are Prednisone and budesonide.
Doctors prescribe the intake of steroids, 5-Aminosalicylates, antibiotics, and biologics.
Lifestyle changes are helpful in treating this disease. You can work towards detoxification and de-stressing yourself to get rid of the flare-ups. Take up some exercises, meditation and Yoga for best results.
You can also control chronic diarrhea by keeping a check on what you eat. You should avoid eating fibrous diet. Fibres are tough to digest for patients with UC. You must maintain proper hygiene as well to stay away from diarrhea.
Surgical Management of Ulcerative Colitis

Ulcerative colitis (UC) is an inflammatory disease of the colon and rectum limited to the mucosa, and may vary in severity from a mild intermittent disease to an acute fulminant and potentially fatal disease requiring urgent surgery. Management of ulcerative colitis depends on severity, extent, and duration of the disease, response and tolerance to medication, patient age and comorbidity as well as patient preference.

Surgery plays an important role in the management of UC both because of the premalignant nature of the disease, and because of the periodic failure of medical management. The underlying rationale for surgical treatment of the disease is that the disease is confined to the colon and rectum, and therefore proctocolectomy is curative. The goal of surgical therapy for ulcerative colitis is to remove the disease with as little alteration of normal physiological functions and lifestyle as possible.

Four surgical options exist for patients with ulcerative colitis and each has its own advantages and disadvantages.

The surgical choices are:

Proctocolectomy and Brooke ileostomy.
Abdominal colectomy and ilcorectal anastomosis.
Proctocolectomy and Kock pouch.
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA).
The choice of operation requires consideration of the advantages and disadvantages of each option and must be tailored to an individual patient's needs and circumstances. Important factors to be considered in the choice of operation include the indication for surgery, age, associated medical conditions, body habitues, and quality of the anal sphincter. Extensive preoperative education is required which should include discussion with a specialized Gastroenterologist.

Ways To Deal With Ulcerative Colitis!

Colitis is characterized by an inflammation of the large intestine (colon). It is generally caused due to reduced blood supply, autoimmune reactions (wherein the immune system erroneously starts attacking the body s healthy tissues) and infections in the large intestine.

Symptoms of colitis
1. Presence of blood traces in the stool.
2. Acute colitis can itself be a symptom of hemorrhoids (inflamed and swollen veins in the anus or the rectum)
3. Tenesmus (constant urge to empty the bowels) is also quite common
4. Occurrence of abdominal pain in regular intervals, thus resulting in diarrhea
5. Constant abdominal pain
6. Fever and sudden chills throughout the day

Types of colitis
1. Inflammatory bowel disease: This condition is characterized by inflammation of the intestines or all the parts of one s digestive tract
2. Microscopic colitis: This involves inflammation of the large intestine (colon), resulting in a cramping sensation that can be painful
3. Chemical colitis: This condition is caused due to prolonged exposure to certain harsh chemicals which results in intestinal swelling and inflammation
4. Ischemic colitis: The most common form of colitis, this occurs mainly due to an insufficient blood supply to the large intestine
5. Infectious colitis: Caused due to certain bacterial or parasitic infections

Treatment for colitis
1. Medications such as acetaminophen and ibuprofen can be recommended to ease the pain
2. The drug  Loperamide  can control the diarrhea. However, this should not be consumed if there is presence of blood in the stool
3. Colitis reduces your appetite. Thus, it is important to maintain a healthy diet in this regard. Avoid consuming dairy products or high fiber foods because they further inflame the large intestine.
4. Colectomy (surgically removing a part of the whole of the colon) is recommended in the most severe of cases.

Colitis - 5 Common Types!

This is a disease that affects the large intestine and the rectum. The Ulcerative Colitis refers to the inflammation in the innermost lining of the large intestine. The main function of the large intestine is to absorb water from indigestible food matter in the body before throwing away any waste. Hence, the large intestine is a vital part of our body. If left untreated, the disease increases risk of colon cancer.

Symptoms:

    Diarrhea with blood or pus: A person suffering from Ulcerative Colitis is likely to suffer from loose stools accompanied with blood or pus.
    Stomach pain and Cramping: In many cases, patients complain of severe stomach pain and cramping.
    Rectal pain: At times, many patients feel pain while sitting or even after a bowel movement.
    Bleeding from the rectum: Bleeding can be observed while passing stools.

The other complications leading to this disease are kidney stones, swelling of the colon, thickening of intestinal walls and blood infection.

Diagnosis:
This disease can be diagnosed by several methods. A simple stool test may be done to check out for bacteria and parasites. A blood test to check the level of C-reactive protein helps determine the inflation rate of the body. Endoscopy, colonoscopy, biopsy are some other methods of diagnosis.

Treatment

    Oral medication: Treatment involves drug therapy or surgery. The first step in treating Ulcerative Colitis will be an intake of anti-inflammatory drugs, but these may have a side effect. Another option is immune system suppressors, which help to bring down the inflammation by suppressing the immune system response. Antibiotics, anti-diarrheal medications, pain relievers are some of the additional drug supplements recommended by doctors.
    Surgery: Surgery plays an important role because this disease is pre-malignant in nature. Depending on the severity of the condition, the medical practitioner may advice surgery. The common methods of surgery are:
        Proctocolectomy and Ileostomy: Proctocolectomy involves removal of the colon in part or whole. Ileostomy is carried out by placing a special bag in the small intestine to collect waste from the body.
        Proctocolectomy and Ileo-anal: Ileo-anal pouch is a bag directly created the small intestine and connected to the anus, for diffusing the stools. As colon is removed Ulcerative Colitis cannot re-occur.

Precautions after surgery
It is very important that the patient takes healthy, sufficient and nutritious food so that bowel movement can be carried out with ease and zero strain. The patient has to restrict lifting of heavy grocery, mowing the lawn, any physical activity that can strain the abdomen and related areas.

Surgery and Post Surgery Care for Ulcerative Colitis

There has been an intense debate, which is in the loop for years and has been raging back and forth regarding the deficiencies of a vegetarian diet versus the perils of a non-vegetarian one. This heated debate is both accurate as well as unfounded. Probably, that s the entire reason it is still a debate. In fact, if you look into the diet of both groups, you will be able to identify the fact that, there is a space for healthy living in both.

Vegetarian Diet

In a vegetarian diet, the food intake of a person is confined to a large variety of foods derived from plants along with milk and dairy. And, any form of meat and products derived from animals are completely avoided.

Pros

Vegetarians have been noted to consume lesser amount of proteins, but they do not suffer from problems related to a high protein diet, such as osteoporosis (characterized by brittle and weak bones) and kidney failure.
The diet includes high level of antioxidants such as vitamin E & C as well as carotene, which is available in vegetables and fruits.
Additionally, they consume less amount of saturated fats.
Cons

Deficiency of vitamin B12 is common amongst vegetarians, as it is mainly available in meat, eggs and fish. Deficiency of vitamin B12 can yield rare symptoms such as increased fatigue, shortness of breath and a temporary loss of body balance.
Lack of protein, as stated above, along with iron and zinc deficiency is also common. 
Symptoms of protein deficiency can be troublesome and include signs like

Sluggish metabolism
Loss of body muscles (as the body tries to derive the regular protein intake from your muscles, thus making them weak),
Trouble gaining or losing weight
Persistent fatigue
Longer healing time in case of wounds and injuries
Pain in joints
Drastic changes in blood sugar level that might result in diabetes
A weak immune system makes you vulnerable to all kinds of diseases.
Non-vegetarian Diet

A non-vegetarian diet includes all forms of plant foods as well as foods and by-products that are derived from animals, such as poultry, fish, meat, etc.

Pros 

Vitamin B12 is present in adequate level since they are derived from sources such as meat, eggs and fish. Adequate intake of proteins is never an issue for  non-vegetarians
Cons

Meat products are loaded with saturated fats, which increase the risk of heart diseases. Studies have shown that people consuming non-vegetarian diets:
Have shorter lifespan and are more vulnerable to chronic diseases.
Tend to develop diabetes, heart diseases and hypertension.
Usually non vegetarians eat less amount of vegetables and fruits than what is recommended.  
If you wish to discuss about any specific problem, you can consult a Dietitian/Nutritionist.

Vegetarian vs Non Vegetarian Diet - Which is Better?

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