How can stomach bleeding be diagnosed?
In case of suspicion of stomach bleeding, the stomach contents expelled by vomiting are red blood colored (mematemesis) or black like tar. it could be the subject. Apart from this, if there is stool that is red blood colored or black like tar (melena), stomach bleeding is suspected. Apart from bleeding that can cause these color changes, some factors may be mistakenly perceived as stomach bleeding. Vomiting after drinking red fruit juice (pomegranate, cherry, tomato juice, etc.) may be mistaken for stomach bleeding. Vomiting in the form of coffee grounds after drinking coffee may be mistaken for stomach bleeding. Apart from this, black stools after the use of iron-containing blood medications may be mistaken for stomach bleeding. To eliminate these inaccuracies, a fecal occult blood test can be performed. While some occult blood tests only detect the presence of blood in the stool, some tests are not so sensitive and may mistakenly give results as if there is blood in the presence of protein (meat protein) in the stool. For this reason, care should be taken at what stage a fecal occult blood test is performed. If we answer the question at what stage a doctor should be consulted, considering the conditions mentioned above, a doctor should be consulted urgently when red or black color is seen in ablution or vomit.
Feeling as if you are going to faint. Straining, fainting, palpitations, dizziness, low blood pressure, shortness of breath, cold sweats may be indirect symptoms of stomach bleeding. Patients should be careful when using medications that frequently cause stomach bleeding.
A definitive diagnosis can be made through detailed examinations such as gastric lavage or endoscopic interventions performed by a gastroenterologist to evaluate whether a person has stomach bleeding. If the application to the gastroenterologist is made as soon as possible, the necessary evaluation and treatment will be possible.
- Stomach Perforation, How to Understand?
Stomach (perforation) is understood as the puncturing of the ulcer located in the stomach. �r. While the term gastric perforation is generally used for the stomach, it is also misunderstood as stomach perforation in the case of duodenal perforation. Although the perforation and clinical findings of both organs are similar, they may show some differences. Perforation may occur due to an ulcer. As is known, an ulcer can occur when a wound extending through all layers of the stomach or duodenum opens into the abdomen or the posterior abdominal wall. The perforation of the ulcer located on the back side of the stomach or duodenum is usually towards the pancreas organ. For this, the term penetration (window opening) rather than puncture is more appropriate. In such a development, the patient's pre-existing abdominal pain may become more severe and spread towards the back. It needs to be evaluated urgently, but often there is no need for an urgent operation. When the stomach or duodenum is punctured, the hole is opened towards the abdomen. From here, the contents of the stomach or duodenum are emptied into the abdomen. This leak, which is acidic or alkaline and may contain bile, occurs in the abdominal membrane (peritoneum)quickly (within 6-8 hours)peritonitis (inflammation of the abdominal membrane) creates. Initially, when the puncture first occurs, the patient may feel a very severe pain in the abdomen, as if stabbing a knife. Complaints such as nausea and vomiting may be added. The patient may experience a period of relaxation 1-2 hours after the puncture, giving the misleading impression that there is no problem. If the patient does not consult a doctor within this period, more serious problems may occur. On the contrary, he may consult a doctor during this relaxation period and if he states that "I had stabbing pain 1-2 hours ago but it is gone now", he may mislead the doctor. If the doctor does not keep the patient under observation and perform the necessary tests, the puncture may be missed. If the perforation is noticed in this period and an emergency operation is performed, the chance of success of the treatment is very high.
Depending on the person's constitution, widespread peritonitis occurs in the abdomen 6-12 hours after this silent period, and the chance of success of the emergency operation to be performed during this period is one. will be lower compared to the previous period.
In the patient with suspected perforation, take a diaphragm on a standing solid abdominal radiograph. The diagnosis is made by seeing free air (subdiaphragmatic air) in the air. If free air is not visible on the radiograph, perforation is not excluded. After giving air by inserting a nasogastric tube (a probe inserted into the stomach through the nose) or after giving air by performing endoscopy, it is checked whether there is air in a standing direct abdominal radiography or abdominal tomography. In this case, if air is not detected, perforation can be excluded.
SMALL INTESTINES:
- What is celiac disease?
Celiac disease is a familial disease that occurs in people who are genetically predisposed to this disease. Although the disease concerns the small intestines, it affects many systems in our body. It occurs with hypersensitivity to gluten contained in grains and grain products. It is an autoimmune disease that concerns the immune system in our body. The immune response (attack) that develops against gliadin during hypersensitivity to gliadin, one of the prolamins found in the structure of wheat, barley, oats, rye and oats, causes a damaging result in the small intestine. HLDQ2is important in genetic predisposition.
- At what age does Celiac Disease occur?
Childhood in Celiac disease It may occur in children with a genetic predisposition to encounter grains and grain products in the first 3 years of age. In adulthood, it can be seen frequently in the 30s and 40s. Celiac disease can be recognized at any stage after the first 3 years of life.
- When should we suspect celiac disease?
Complaints in people with celiac disease may vary widely, or they may not have any complaints at all. Typical complaints are abdominal pain and diarrhea. These complaints can be seen in a wide range. It can cause an emergency, ranging from a mild abdominal pain to an acute abdomen, and symptoms can range from mild diarrhea to diarrhea that can cause serious weight loss. In cases that apply to these different patient clinics, the doctor comes to mind and undergoes examination. A conclusion can be reached by requesting the symptoms.
Apart from the classic complaints of abdominal pain and diarrhea, the disease can also be seen in difficult-to-think complaints that are not considered to be Celiac. These include anemia, transaminase levels (elevated liver function tests), long-lasting and unexplained fatigue, infertility, frequent miscarriage. ), giving birth to low birth weight children, frequent intrauterine infant deaths (inutero mort fetal), gum abnormalities, joint inflammations (arthritis), osteoporosis Symptoms involving multiple systems, such as (bone loss), may also be related to Celiac disease.
- How is Celiac disease diagnosed?
The definitive diagnosis of celiac disease is made by small intestine biopsy, presence of tissue transglutaminase antibody, anti-endomysial IgA antibody and clinical evaluation of the patient. If serological tests (antibodies) are positive and the small bowel biopsy is positive, the patient is monitored and the small bowel biopsy and antibody serological tests are repeated at 1-2 year intervals. If serological tests are negative and biopsy is negative, Celiac disease is ruled out. The gold standard is biopsy findings.
- What is the role of the HLADQ2 test in the diagnosis of celiac disease?
HLADQ2genetics It is one of the tissue antigens that occur in the natural structure of the individual through transition. The risk of developing Celiac disease increases in people with this genetic structure. Although this does not have a precisely determined numerical value, it gives an idea if it is examined in the children of people with celiac disease, but it does not mean that the child will definitely have the disease in the future by showing clinical symptoms. HLA DQ2 is inadequate for use as a screening test. Diagnosis accuracy will increase when small bowel biopsy is added when necessary.
- What complaints and digestive system diseases are important in the complaints of celiac disease, apart from abdominal pain and diarrhea?
Abdominal pain and diarrhea associated with gastrointestinal system complaints and diseases (malabsorption - insufficient food absorption findings)as well as constipation, abdominal bloating, weight loss, atrophic glossitis (changes in taste sensation in the tongue), aphthous ulcers in the mouth, refractory gastroesophageal reflux (treatment-resistant reflux) Strong>, eosinophilic esophagitis, recurrent pancreatitis, elevated transaminase (elevated liver function tests), autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, steatohepatitis, inflammatory bowel disease. These diseases and complaints can be associated with Celiac disease.
- Which systems-related complaints and diseases other than the digestive system can we encounter in Celiac disease?
Dermatitis herpetiformis as a skin disease other than the digestive system, thyroiditis (inflammation of the thyroid gland) related to the endocrinological system, autoimmune thyroiditis, vitamin D and calcium deficiency, osteopenia, osteoporosis (bone loss), type I diabetes mellitus ( diabetes), infertility, recurrent miscarriages, endometriosis, myocarditis, idiopathic dilated cardiomyopathy (heart failure), myocarditis (inflammation of the heart muscle Celiac disease coexists or is associated with many diseases such as IgA nephropathy, anemia due to iron, B12 and folic acid deficiency, hyposplenism, rheumatoid arthritis and Sjögren's syndrome. For this reason, when many complaints and disease symptoms are encountered, the doctor should think of Celiac disease.
- How is a small intestine biopsy taken in the diagnosis of Celiac disease?
For the diagnosis of celiac disease, histopathological detection of villus atrophy findings in small intestine biopsy is the gold standard method (the most valuable in making the diagnosis). For this purpose, during the endoscopic examination of the upper gastrointestinal system, a biopsy should be taken from the second segment of the duodenum (in gastroscopy) and sent to pathology. Very important data in diagnosis can be obtained through evaluation by a pathologist experienced in the field of the digestive system.
- What is the relationship between celiac disease and cancer?
Non-Hodgkin's disease in the course of celiac disease
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