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?

A peptic ulcer is usually found in the duodenum, or the first part of the small intestine. These ulcers can also be found in the delicate stomach lining near this region. These are usually painful sores that are caused due to too much acid production in the stomach, as well as excessive smoking and alcohol consumption. The symptoms generally include heartburn, bloating, nausea, vomiting, and even blood discharge in stool and vomiting. So how can you treat these ulcers? Here's a short list of ways to do so.

- Medication: The most common way of treating peptic ulcers is to ingest proton pump inhibitors which can be prescribed by a general physician. These medicines will effectively stop the production of acid and reflux in the gastroesophageal band, so as to prevent the growth and production of such ulcers. Antibiotics can also help, especially in severe cases where there is a risk of infection due to the presence of these ulcers.

- Upper Endoscopy and Surgery: For severe cases where there is bleeding in the peptic ulcers, an upper endoscopy may also be conducted. This quick procedure can give relief from the bleeding. Also, many specialists might recommend surgery so as to treat an ulcer that has punched a hole in the stomach's wall, in which case the persistent bleeding cannot be stemmed even with an upper endoscopy.

- Lifestyle Choices: The presence of a peptic ulcer usually points to tobacco and alcohol abuse. If you happen to be over 50 years of age and are busy drinking copious amounts of alcohol every day and even chain smoking, then you may be at risk. It is best to stop such abuse by giving up smoking and drinking so as to ensure that the peptic ulcer can be treated and does not become a fatality. Also, drinking plenty of water and eating a proper balanced diet along with exercise are some of the best ways of treating these ulcers.

- Side Effects: Peptic ulcers may also arise as a side effect of having pain killers too frequently. So it is important to stay away from medication that gives rise to this kind of reaction in the body.

Managing and treating peptic ulcers is a matter of getting the right tests done for diagnosis before discussing further medication or surgery based treatment for the ulcer so that it does not pose any grave danger to the patient's body.

Coping with Peptic Ulcers

Ulcerative colitis is a chronic inflammatory condition whereby, tiny abscesses and ulcers are formed on the inner lining of the large intestine, or on the colon or rectum. These ulcers may burst frequently resulting in diarrhea and bloody stools. This disease may also be responsible for causing anemia as well as harsh abdominal pain.

Ulcerative colitis normally alternate periodically from flaring up to receding quickly. These periods of remission can either last for weeks or maybe, even for years at a stretch. They are, however, not permanent and although the disease may seem to have disappeared completely, it can soon show up again in no time. Usually beginning in the rectum, it can, by and by, spread rapidly to other parts of the colon. If it is, however, limited only to the rectum, then it is more commonly referred to as ulcerative proctitis.

Surgery is generally obligatory and mandatory when it comes to treating ulcerative colitis. If surgery is not performed, you may suffer from long-lasting side effects, including cancer and colon rupture. Here are the different types of surgery that you may undergo:

1. Colectomy: This is done when the entire colon needs to be removed and is usually performed to eliminate the perils of acquiring colon cancer.

2. Proctocolectomy: This concerns the total removal of both colon and rectum and is usually the standard procedure when dealing with ulcerative colitis.

3. Ileal Pouch Anal Anastomosis: If the treatment does not require a permanent stoma, and if you can still manage to let out stool from your anus, then this surgery, also called restorative proctocolectomy would be most appropriate.

Here, both colon and rectum are removed, but at the same time, the small intestine is utilized to form an internal reservoir, called a J-pouch, which is linked to the anus and can hereafter serve as your new rectum.

Types Of Ulcerative Colitis Surgery

Ulcerative Colitis is a chronic inflammatory disease that affects the lining of the intestine and the rectum. It is located just above the anus. Patients suffering from ulcerative colitis tend to have small ulcers in their rectum and the colon. These eventually flare up leading to diarrhea, bloody stools, anemia and abdominal pain. The inflammation starts from the rectum and eventually, spreads to the colon. Ulcerative Colitis tends to flare up and remit in an alternate phase. The remission can last from few weeks to few years.

Methods adopted to diagnose Ulcerative Colitis-
Ulcerative Colitis is very similar to an inflammatory bowel disease known as Crohn s disease. The only differentiating factor is the fact that, ulcerative colitis affects the colon whereas, Crohn s disease affects the digestive system and the small intestine. A doctor might prescribe certain tests such as the colonoscopy, blood tests, CT scan, pill camera, stool sample tests etc.

Why is surgery necessary to treat Ulcerative Colitis?
An estimated 40 percent of all Ulcerative Colitis patients need to undergo surgery to recover completely. The reason surgery becomes necessary to treat ulcerative colitis are the following:

Drug therapy and medication become ineffective.
Without undergoing surgery, the condition might increase the risk of developing cancer.
The colon has the risk of getting ruptured if surgery is not performed on time.
There could be excessive bleeding.
Toxic megacolon might set in.
Types of surgery available to treat Ulcerative Colitis
A procedure where the entire colon is removed is known as the colectomy. In case both the colons are removed, the procedure is termed as proctocolectomy. In this procedure, an external pouch needed to be attached to the stoma that collects the stools. There is another method known as pouch surgery. 

Pelvic pouch or ileal pouch is also termed as IPAA. This procedure doesn t involve permanent stoma. In this procedure, both the colon and the rectum are eradicated from the body. The small intestine is then used to form a J-shaped pouch, that serves as the new rectum. The pouch is then connected to the anus. The whole procedure is done via two surgeries.

What are the surgical complications of this procedure?

There could be an excessive bowel movement.
There are instances where an inflammation of the pouch is observed. This condition is known as pouchitis.
There could be a situation of intestinal blockage from adhesion due to surgery.
There could be pouch failure that can happen inside within 5 few years. This is observed in 4 out of 100 patients who are treated. In this case, the patient should go for a permanent ileectomy.

Ulcerative Colitis - What You Need To Know?

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!

There are many different Ayurvedic medicines used in the treatment of ulcerative colitis, and one of the most common ways of treatment is to use a combination of the four best medicines, which work in unison to get rid of the disease.

Kutazghan vati: This medicine is derived from the tree Kutaz. Its scientific name is Halorrhreana anti dysentrica. The name itself suggests how effective the tree is in treating the disease. Diarrhea can occur due to many reasons, and one of the reasons is ulcerative colitis. If diarrhea is due to this, then it can get treated by taking Kutazghan Vati tablets, which are made from the bark of the tree.
Pitta balance with calcium compounds: When pitta or the gastric juices flow more inside the intestines, it leads to bleeding due to the ulcers inside, which needs to be balanced and controlled. The use of calcium compound rich Ayurvedic medicines serve the perfect remedy. Calcium is extracted from naturally occurring things like pearls and corals. When the tablets made from such calcium compounds are consumed, the inflammation within the colon goes down, bleeding reduces and gradually stops, and the internal irritation diminishes.
Vatsakadi churna: Tablets made from elements like fennel, coriander, Aegle Marmelos, Nutmeg, pomegranate, Green Cardamom, work like magic in treating ulcerative colitis. These are all ulcer healing items, proven beneficial for ages, and cure fast. The main function of a combination of these herbs is in restoring the metabolic imbalance carried on in the body. The ulcers are healed soon with their use, and the body balance is restored.
Arjuna capsules: One of the wound healing barks, really very famous in Ayurveda, is the bark of the Arjuna (Terminalia Arjuna) tree. This helps in many ways to heal wounds, and specially the endothelial layer inside the body arteries are healed from injuries related to free radicals, stress and other toxins. The same effects of the Arjuna tablets are seen inside the inner layers of the intestines. The ulcers are cleaned with time with the consumption of these tablets, while the bleeding also stops, and the diarrhea which was due to the inflamed colon gets cured. Moreover, the hemoglobin level is also normalized in the body, which was once affected due to bloody diarrhea.
Ulcerative colitis is a painful situation, but can be healed totally with proper administration of Ayurvedic medicines. These 4 essential medicines must be taken in combination without suddenly stopping them. They must be continued until the symptoms and irritation go away.

Ayurvedic Treatment For Ulcerative Colitis!

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