Very informative. I’ve experienced two fairly serious GI bleeds one of which my pulse and hemoglobin levels were very low. Specialist has done endoscopy, colonoscopy and capsule endoscopy which were all inconclusive. Also tested negative for H-pylori. Everything was fine for about 15 months and now I’m experiencing GI bleed episode again with melema. The ONLY thing that I’ve done differently is started to take ibuprofen again a few weeks ago (hadn’t done so for over 15 months). Waiting to see specialist again, but wonder whether ibuprofen is what did it.
It could be as Ibuprofen is an NSAID and NSAIDs can cause stomach ulcers, which can lead to severe bleeding. To confirm this you would need to consult your doctor. Try discussing with your doctor if you could use an alternative instead of Ibuprofen.
So you think that taking Ibuprofin might have caused the ulcers? Has it been confirmed? Is your GI bleeding? Did your faeces smell? How long have you been having the symptoms?
Irritation with the Stomach upper Gi tract symptoms is so frustrating I’m beginning not to even care about it anymore The pain in my side whenever I eat too much of something sugar along with gas and black stool during that process is very irritating especially since it’s happened out of the Blue. I’ll wing it just like I do most things I don’t like bringing my family into my health issues.
I have a large hiatial hernia and spent the night vomiting blood and lost a copious amount in stool. So off to the ER I went. I have been being treated for this hernia and esophageal stenosis which has caused severe anemia. I have 4 iron infusions over the last 8 months. I also have multiple diverticuli.
@@TheBlueLotus777I had my surgery to fix the hiatial hernia. The surgeon also performed a fundiplacation to help stop the GERD. What an amazing difference the surgery has made. Thank you for asking
Why are upper GI bleeds associated with more blood loss/hemodynamically unstable compared to lower GI bleed? Is it because of pressure differences of the blood supplies? Thank you for your videos. They have been very helpful on my IM rotations.
I don't know for certain, but I would hypothesize that it's the consequence of 2 things: 1. Esophageal varices as an etiology has much higher mortality than any other common cause of GI bleeding, which pulls up the overall mortality for all upper GI bleeds. 2. Most of the common etiologies of upper GI bleeds (e.g. varices, gastritis, PUD) are associated with other conditions that are huge mortality risk factors in general or often come with preexisting anemia and abnormalities of hemostasis (e.g. cirrhosis, alcoholism), whereas the most common etiologies of lower GI bleeds (e.g. hemorrhoids, diverticulosis, AVMs) typically occur on their own.
Thanks for reminding me! I just added a new folder for the Approach to Symptoms videos, and put 6 pdfs there (drive.google.com/drive/u/0/folders/1sYXI-9uBN7t6Ah2iKefoU4MshSSUSsRw ). Will add more when I have time.
Scariest moment was my upper GI bleed (massive). (Due to medications). I didn’t know that I have cirrhosis so bad that my liver couldn’t filter the blood backed up into my esophagus into the vases and I was throwing up a lot of blood. Mass General Hospital saved me ❤❤
I’ve been diagnosed with the hematmesis and was released from hospital a few months ago. In the last 3 days I’ve been having chest pains. Should I be concerned. I take paracetamol and the pain goes away for a few ours but comes back again.
I'm sorry but I can't offer specific, individualized medical advice on here, though new onset chest pain is something that you should take seriously. I recommend speaking with your physician.
Hello Dr. Strong, I have a few questions regarding NGT insertion if you would kindly answer them, as I am very conflicted about their efficacy and general use You mention the use for evaluating blood presence and severity of ongoing hemorrhage in gastric lavage and how it is generally going out of favor. I was wondering if there were any other uses for gastric lavage, specifically: -Aspiration of potential blood to prevent constipation and degradation of ammonia in a patient with a history of hepatic encephalopathy Is there any clinical data regarding that? I've read conflicting evidence online and would love your input.
I got GIB due to aspirin last yr., ct scan result is diverticulosis. Last week took turmeric tea and garlic oil supp but again GIB is under observation.. so i need to avoid blood thinner med or supp or food that have blood thinning effect😌😌😌
Im from houston and was told there was blood in my stool , they want to do an endoscopy and just wanted to see if a colonoscopy was better or the capsule endoscopy
Great presentation. Very clear, concise and succinct. A quick question though.. can you please name few most common specific treatments as well? Thanks
Hi can someone help? I have had black stool from Tuesday and it is now Monday for me. I didn’t pass a stool for 2 days and I passed one 5 minutes ago and it doesn’t seem as dark as it was and only a trace amount of blood whereas before it was quite a lot. Does this mean it’s ok now or what should I do? I’ve had a pain in the left side of my stomach for a good few days now as well and it triggers when I have a bowel movement and when I eat. I believe this may be a stomach ulcer but I am not sure. I got tablets from A&E and they told me I have a respiratory tract infection which I don’t understand has anything to do with my black stool. My bloods and urine came back normal. What should I do?
I'm very sorry, but I cannot offer specific, individualized medical advice here. I strongly recommend speaking with your own physicians about your medical concerns.
Thanks for the suggestion! This is on the "long list" - meaning a topic that I'm planning to cover, but with so many other great suggestions, and because I missed the point in the year when this material is covered at my own med school, it probably won't be for a while.
I didn't mean to imply that the hemoglobin level is not important at all. But if I had 2 patients with an acute GI bleed: Patient #1: Looks fine, vitals normal, hemoglobin level 7 g/dL. Patient #2: Looks ill, hypotensive and tachycardic, hemoglobin level 10 g/dL. ...I would be much more worried about patient #2.
The is the best video concerning GI Bleed I have seen m. Easy to comprehend.
Your diagrams are the best Dr. Strong!! Thank you so much for your efforts and time.
Great video , this is so complete and simple.
Thank you
Why didn't i find out this channel sooner.
Thank u soo much
Simply excellent. Very grateful for clear, concise and well presented video. Thank you for the great channel. 😊😊 7/9/2019
Very informative. I’ve experienced two fairly serious GI bleeds one of which my pulse and hemoglobin levels were very low. Specialist has done endoscopy, colonoscopy and capsule endoscopy which were all inconclusive. Also tested negative for H-pylori. Everything was fine for about 15 months and now I’m experiencing GI bleed episode again with melema. The ONLY thing that I’ve done differently is started to take ibuprofen again a few weeks ago (hadn’t done so for over 15 months). Waiting to see specialist again, but wonder whether ibuprofen is what did it.
It could be as Ibuprofen is an NSAID and NSAIDs can cause stomach ulcers, which can lead to severe bleeding. To confirm this you would need to consult your doctor. Try discussing with your doctor if you could use an alternative instead of Ibuprofen.
So you think that taking Ibuprofin might have caused the ulcers? Has it been confirmed? Is your GI bleeding? Did your faeces smell? How long have you been having the symptoms?
so helpful for medical students all over the world. GBU!
Irritation with the Stomach upper Gi tract symptoms is so frustrating I’m beginning not to even care about it anymore
The pain in my side whenever I eat too much of something sugar along with gas and black stool during that process is very irritating especially since it’s happened out of the Blue.
I’ll wing it just like I do most things I don’t like bringing my family into my health issues.
Thanks doc! Thorough unlike some videos
Your educational videos are the best
Very Clear and Organized. Thank you!
Great video! Easy explanation and tables are so helpful
I have a large hiatial hernia and spent the night vomiting blood and lost a copious amount in stool. So off to the ER I went. I have been being treated for this hernia and esophageal stenosis which has caused severe anemia. I have 4 iron infusions over the last 8 months. I also have multiple diverticuli.
Are you okay?
@@TheBlueLotus777I had my surgery to fix the hiatial hernia. The surgeon also performed a fundiplacation to help stop the GERD. What an amazing difference the surgery has made. Thank you for asking
Bro are u okay now?
Great Doctor you certainly cover a great deal step by step procedure excellent!!!
A very practical and interesting series .. thank you
Thank you so much,may i ask you to explain what to do before passing the patient to the endoscopy ward?
Why are upper GI bleeds associated with more blood loss/hemodynamically unstable compared to lower GI bleed? Is it because of pressure differences of the blood supplies? Thank you for your videos. They have been very helpful on my IM rotations.
I don't know for certain, but I would hypothesize that it's the consequence of 2 things:
1. Esophageal varices as an etiology has much higher mortality than any other common cause of GI bleeding, which pulls up the overall mortality for all upper GI bleeds.
2. Most of the common etiologies of upper GI bleeds (e.g. varices, gastritis, PUD) are associated with other conditions that are huge mortality risk factors in general or often come with preexisting anemia and abnormalities of hemostasis (e.g. cirrhosis, alcoholism), whereas the most common etiologies of lower GI bleeds (e.g. hemorrhoids, diverticulosis, AVMs) typically occur on their own.
Thank you. This is very helpful.
Thank you a lot sir. Do you think about adding your new lectures to the Drive account?
Thanks for reminding me! I just added a new folder for the Approach to Symptoms videos, and put 6 pdfs there (drive.google.com/drive/u/0/folders/1sYXI-9uBN7t6Ah2iKefoU4MshSSUSsRw ). Will add more when I have time.
@@StrongMed Thank you,where can we find the other simmilar PDFs?
So clearly explained ! Thankyou
Scariest moment was my upper GI bleed (massive). (Due to medications). I didn’t know that I have cirrhosis so bad that my liver couldn’t filter the blood backed up into my esophagus into the vases and I was throwing up a lot of blood. Mass General Hospital saved me ❤❤
Esophageal variceal bleeds are one of the scariest things a hospitalist can encounter.
Wouldn't an mri with contrast afford a better less invasive means of diagnostic result?
I’ve been diagnosed with the hematmesis and was released from hospital a few months ago. In the last 3 days I’ve been having chest pains. Should I be concerned. I take paracetamol and the pain goes away for a few ours but comes back again.
I'm sorry but I can't offer specific, individualized medical advice on here, though new onset chest pain is something that you should take seriously. I recommend speaking with your physician.
Hello Dr. Strong,
I have a few questions regarding NGT insertion if you would kindly answer them, as I am very conflicted about their efficacy and general use
You mention the use for evaluating blood presence and severity of ongoing hemorrhage in gastric lavage and how it is generally going out of favor. I was wondering if there were any other uses for gastric lavage, specifically:
-Aspiration of potential blood to prevent constipation and degradation of ammonia in a patient with a history of hepatic encephalopathy
Is there any clinical data regarding that? I've read conflicting evidence online and would love your input.
Thanks for your video.
I got GIB due to aspirin last yr., ct scan result is diverticulosis. Last week took turmeric tea and garlic oil supp but again GIB is under observation.. so i need to avoid blood thinner med or supp or food that have blood thinning effect😌😌😌
excellent
Some GI almost makes me want to be a gastroenterologist because it’s so interesting.
Im from houston and was told there was blood in my stool , they want to do an endoscopy and just wanted to see if a colonoscopy was better or the capsule endoscopy
I hope the video was helpful, but unfortunately, I can't give specific, individualized medical advice here.
Great presentation. Very clear, concise and succinct. A quick question though.. can you please name few most common specific treatments as well? Thanks
Sir kindly make a video on seizures..all types and management
thank you
regards
It took a few years, but I finally got to it! ua-cam.com/video/Iv1a4bOL_k0/v-deo.html
This is good.
I had a Upper GI Bleed caused by ibuprofen, this video helped me understand what was happening inside me ;)
How did you treat it? How was it diagnosed? Did you go through colonoscopy?
fantastic lecture. Thanks a lot
Hi can someone help?
I have had black stool from Tuesday and it is now Monday for me. I didn’t pass a stool for 2 days and I passed one 5 minutes ago and it doesn’t seem as dark as it was and only a trace amount of blood whereas before it was quite a lot. Does this mean it’s ok now or what should I do? I’ve had a pain in the left side of my stomach for a good few days now as well and it triggers when I have a bowel movement and when I eat. I believe this may be a stomach ulcer but I am not sure. I got tablets from A&E and they told me I have a respiratory tract infection which I don’t understand has anything to do with my black stool. My bloods and urine came back normal. What should I do?
I'm very sorry, but I cannot offer specific, individualized medical advice here. I strongly recommend speaking with your own physicians about your medical concerns.
Thanks sir. It was so helpful
jail
Thank you.....👍🏻
Thank you sir.
So good
Thankyou so much
please make a video about chemical transmission ( (nor)adrenaline _acetyl choline) ,
and thanks sir
Thanks for the suggestion! This is on the "long list" - meaning a topic that I'm planning to cover, but with so many other great suggestions, and because I missed the point in the year when this material is covered at my own med school, it probably won't be for a while.
great one sir
Thank you 🙏
Why we give beta blokr in upr gi bleeding
Tanzeel zainab what is the mechanism of action B blocker? Its the answer 👌
@@drmfdmfd4080 they also reduce the effect of epinephrine which is vasoconstrictor..than how..
Tanzeel zainab R U SURE ITS VASOCONSTRICTION ???!
If the pt have high BP will u give norepinephrine ?!
Decrease varices growth and decrease risk of rupture its decrease portal pressure
tak!
Thanks
HELP..... I've been pooping out YELLOW LIQUID.. WTF!?
NO ORDINARY BULKY-POOP , ONLY YELLOW LIQUID
😲😢😭🤔
Blood no stool no pain?
Molto bene
❤❤❤❤❤
My mother died from this due to neglegence
Thanks a lot
👍
perfect
I'm sure you would laugh if you saw specialists in my country getting worry about hemoglobin levels. I thought it was important.
I didn't mean to imply that the hemoglobin level is not important at all. But if I had 2 patients with an acute GI bleed:
Patient #1: Looks fine, vitals normal, hemoglobin level 7 g/dL.
Patient #2: Looks ill, hypotensive and tachycardic, hemoglobin level 10 g/dL.
...I would be much more worried about patient #2.
Vitals are always more important.
Actually I agree with u. Congrats for your job of teaching us, keep doing you great labor! Good wishes from Venezuela.
Actually I agree with u. Congrats for your job of teaching us, keep doing you great labor! Good wishes from Venezuela.
our professor said hematocrit better than Hb for blood loss