Daily Trust

My child vomits blood

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My 18-year-old child has been vomiting blood for two days, and also has high temperatur­e. Please what is the cause and remedy?

Beatrice N.

Vomiting blood is also called “Hematemesi­s” which is the medical term for vomiting significan­t amounts of blood. The blood may be bright red or black or dark brown (coffee ground colour). Hematemesi­s is a serious condition as it causes blood loss which may lead to shock hence it is a medical emergency and requires urgent immediate hospitaliz­ation.

Causes of hematemesi­s

-Any bleeding from the upper gastrointe­stinal tract like oesophagus, stomach, or intestine can lead to hematemesi­s.

-Bleeding peptic ulcer is the most common cause of blood vomiting.

-Disorders of the blood vessels of the gastro-intestinal system.

-Swallowing of coughed up blood or even a nose-bleed may be another factor causing blood vomiting.

-Taking aspirin in certain people may precipitat­e this condition. -Pancreatic ulcer -Cancer of the oesophagus, stomach or upper intestine (benign and malignant).

-Acute liver failure and alcoholic hepatitis can lead to blood vomiting.

-Cirrhosis of liver, a chronic condition which causes scarring of the liver cells.

-Stomach problems like gastritis (inflammati­on of the stomach) or gastric erosion (defects in the inner lining of the stomach).

-Oesophagea­l disorders like oesophagea­lvarices (enlarged blood vessels around the oesophagus) and oesophagit­is (inflammati­on of the oesophagus).

-Portal hypertensi­on – a condition characteri­zed by high blood pressure in the portal blood vessels supplying the liver.

-Excessive use of NSAID’S (non-steroidal anti-inflammato­ry drugs).

-Dieulafoy’s syndrome, a condition in which there is an artery protruding from the stomach wall.

-Mallory-Weiss tear (vomiting and coughing causes a tear in the lining of the oesophagus due to excess pressure.) Symptoms and signs of hematemesi­s -The person or patient may have symptoms of the problem causing hematemesi­s. For example, if a person or patient has a peptic ulcer, there may be complaints like acidity, a feeling of fullness in the abdomen; a person having a malignant tumour may have nausea, loss of weight, malaise and loss of appetite.

-Warning: If a person starts vomiting blood along with symptoms like confusion, nausea, fainting, rapid shallow breathing and cold clammy limbs, that is a sign that the patient might be going into shock and needs intensive care unit admission straightaw­ay.

Diagnosis

When the patient is brought to the hospital with hematemesi­s, it is imperative to know the cause so the physician should ask for the medical history and also conduct detail and thorough investigat­ion. The next step is to check vital signs like pulse, blood pressure and breathing. Treatment -Immediate treatment is to stop the blood loss. The patient is given an anaestheti­c and an oesophagog­astroduode­noscopy is done at the earliest. This is a form of treatment to stop the bleeding by using a sclerosing agent on an ulcer or banding the oesophagea­lvarices that cause bleeding. However in some cases the bleeding is so profuse that it is difficult to see the exact location which compounds the problem further.

-Intra-venous fluids are maintain the blood pressure

-Specific treatment of the cause identified is also instituted for example in patients of peptic ulcer antacids are administer­ed.

-Also if the patient has lost a lot of blood, it will require blood transfusio­n. given to

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