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?

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!

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?

Eating good and healthy food always contributes to the overall wellbeing of a person. Same holds true for the patients suffering from ulcerative colitis (UC). Ulcerative colitis patients need certain dietary modification to bring about a change in their condition. Though this condition isn t directly caused by the food but the frequency of flare ups is influenced by the food taken. Below mentioned is the list of foods to eat and avoid.

Food to be Consumed
Usually, for ulcerative colitis, low fibre and low residue foods are considered the best since they are easy to digest. Here is a list of foods that can be included in the diet:

Vitamin D: This vitamin boosts the immune system to fight the risks of ulcerative colitis flare ups. Since the sun is the best source of Vitamin D, it is important that a person gets as much exposure to the sun as possible.
Probiotics: Maintain a balance between good and bad bacteria of the gut which in turn alleviates the symptoms of this condition.
Omega-3 fatty acids: Omega-3 fatty acids have an anti-inflammatory effect, which can help alleviate intestinal inflammation caused by ulcerative colitis. Salmon is one of the best sources of Omega-3.
Eggs: Eggs are typically easy to digest and offer a number of nutrients which makes them one of the best choices for the patients of UC.
Plenty of fluid: People with this condition need to drink extra fluid, as diarrhoea can lead to dehydration.
Supplements: Dietary supplements also help in balancing the nutritional needs of a patient. But do consult a 
And last but not the least there are many anti-inflammatory foods that help in reducing the ulcerative colitis flare-ups include turmeric, cloves, ginger and rosemary. 

Foods to be Avoided
A patient should closely monitor what s/he is eating as the studies have revealed that the symptoms of ulcerative colitis are closely associated with diet. The following list will help you cut off the chances of UC flare ups.

High Fibre Food: Are difficult to digest so should be cut off from the diet. It s best to moderate the intake of fruits and vegetables with insoluble fibres.
Oily and Fatty Foods: The greasy food can aggravate the symptoms of UC as well as can cause diarrhoea.
Spicy foods: Spicy foods may disturb your bowel movements, so it is best to limit the intake of chillies, chilli powder, paprika, peppers etc.
Dairy products: Patients of UC are mostly lactose intolerant. So, these patients should avoid dairy products.
Seeds and nuts: Seeds and nuts are hard to digest, and it is best to avoid them if you are suffering from ulcerative colitis.
Ulcerative Colitis is just a disease which can be avoided by maintaining a proper diet and making few dietary modifications. One should eat smaller meals a few times per days instead of eating large ones.

Ulcerative Colitis Diet - Foods To Eat And Avoid!

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

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