home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
CD-ROM Today (UK) (Spanish) 15
/
CDRT.iso
/
dp
/
0198
/
01985.txt
< prev
next >
Wrap
Text File
|
1994-01-17
|
5KB
|
85 lines
$Unique_ID{BRK01985}
$Pretitle{}
$Title{Hematemesis: Causes and Treatments}
$Subject{Hematemesis cause Causes treat treated treatment Treatments liver
vomit vomiting blood bleed bleeding stomach ulcer ulcers cancer cancers
cancerous irritate irritation irritations gastritis esophagus esophageal
varices heart vein veins vessel vessels toxic injury injuries injured damage
damaged damages damaging infect infection infections hepatitis chemical
chemicals detoxify detoxifying alcohol abuse abusing scar scars scarring fiber
fibers fibrous tissue tissues cirrhosis varicose diet diets propranolol
medicine medicines medication medications surgery surgeries surgical
Sclerotherapy operate operation operations portacaval shunt shunts}
$Volume{}
$Log{
Normal Fatty and Cirrhotic Livers*0009701.scf
What Causes Cirrhosis of the Liver*0009702.scf}
Copyright (c) 1993 Tribune Media Services, Inc.
Hematemesis: Causes and Treatments
------------------------------------------------------------------------------
QUESTION: I am a faithful reader of your column. I have learned a lot.
Would you please write about hematemesis and the architecture of the liver.
What causes the problem? What can be done? Thank you for any information you
can provide me.
------------------------------------------------------------------------------
ANSWER: The definition of hematemesis is simple, it means "vomiting blood".
It may be easy to identify when the vomitus is red, occurring when there is
brisk bleeding. In some cases it looks like coffee grounds, for the acid in
the stomach changes the color of the blood to black. Such bleeding may result
from a stomach ulcer, a cancer in the stomach, acute irritation of the lining
of the stomach (gastritis), a tear in the esophagus, or a condition known as
esophageal varices. Since you have also asked about the liver, it is this
last condition that you are concerned with, for it is a change in the
structure of the liver that is the primary cause of the varices, and the
bleeding.
Normally much of the blood returning to the heart through the veins
passes through the liver. There it may be "cleaned", as one of the most
important functions of the liver is to chemically change toxic substances so
that they can not harm the body. However, when the liver itself has been
injured by infection (hepatitis), toxic chemicals, or overworked detoxifying
alcohol (alcohol abuse), it reacts by scarring, forming fibrous tissue that
changes the shape and structure of the liver. This condition is known as
"cirrhosis of the liver". When the scarring becomes extensive, blood no
longer flows easily through the liver, and seeks a new path back to the heart.
It now flows through veins that run in the wall of the esophagus, stretching
them beyond their normal size, creating varices. It is very similar to the
condition you can observe in the leg, when the veins there are enlarged and
swollen (varicose veins). These distended veins can be easily bruised and
damaged by the food passing from the mouth to the stomach, and may rupture and
bleed. The escaping blood then passes into the stomach and may be thrown up,
and seen as hematemesis.
If the damage to the liver can be reversed, it is possible that the
normal pathway for the blood can be restored. Treatment depends upon the
cause of injury to the liver, by withdrawing the drug or chemical that is
responsible for the damage, abstinence from alcohol (when that is the cause)
and providing a nutritious diet to the patient. However, if the condition is
advanced beyond recovery, there are some treatments that can be tried to
reduce the flow through the veins in the esophagus. Some reports reveal that
the use of propranolol may reduce the pressure in these veins, and reduce the
possibility of bleeding. If medications fail, then there are still some
surgical alternatives to turn to.
Sclerotherapy consists of injecting a substance in the esophageal veins
that cause them to scar, sealing the passage to the flow of blood. There is
also an operation that reroutes the blood coming to the liver, to the large
vein that leads to the heart. This is called a portacaval shunt, and leads
much of the blood around the liver. This is a difficult operation, and is not
without its own complication.
Be aware that acute hematemesis in the presence of esophageal varices is
considered a medical emergency and requires immediate and intensive treatment
in a hospital environment.
----------------
The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician. Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.