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Gastrointestinal Bleeding in the Elderly

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Geriatric Diseases

Abstract

Gastrointestinal bleeding is any bleeding into the lumen of the gastrointestinal tract from the oesophagus to the anus. The ageing process together with the co-morbidities and the greater use of medications such as NSAIDs and anticoagulants have a negative effect on the outcome of GI bleeding in the elderly. In the elderly because of the alterations in pain perception and atypical presentation, certain gastrointestinal disorders can present with difficulty in diagnosis. The present review will highlight the causes and discuss the management of gastrointestinal bleeding in the elderly.

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References

  1. Kaplan RC, Heckbert SR, Koepsell TD, Furberg CD, Polak JF, et al Risk factors for hospitalized gastrointestinal bleeding among older patients. J Am Geriatr Soc. 2001;49:126–133.

    Article  CAS  PubMed  Google Scholar 

  2. Longstreth GF. Epidemiology and outcome of patients hospitalised with acute lower gastrointestinal haemorrhage. A population based study. Am J Gastroenterol. 1997;92: 419–424.

    CAS  PubMed  Google Scholar 

  3. Fallah MA, Prakash C, Edmundowicz S. Acute gastrointestinal bleeding. Med Clin North Am 2000;84:1183–203.

    Article  CAS  PubMed  Google Scholar 

  4. Dallal HJ, Palmer KR. ABC of the upper gastrointestinal tract –upper gastric ulcer haemorrhage. Brit Med J. 2001;323:1115–1117.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Chait MM. Lower gastrointestinal bleeding in the elderly. World J Gastrointest Endosc. 2010;2(5):147–154.

    Google Scholar 

  6. Yachimski PS, Friedman LS. Gastroenterology and Hepatology. 2008;5: Review.

    Google Scholar 

  7. Ahmed A, Stanley AJ. Acute upper gastrointestinal bleeding in the elderly. Drugs &Aging. 2012;29(12):933–940.

    Article  CAS  Google Scholar 

  8. Akhtar AJ. Lower gastrointestinal bleeding in elderly patients. J Am Med Dir Assoc. 2003;4(6):320–2.

    Article  PubMed  Google Scholar 

  9. Farrel J, Friedman L. Gastroenterology. Clin North Am. Vol. 30 Issue 2 pp 377–407,2000.

    Google Scholar 

  10. Rocksall TA, Logan RF, Delvin HB, Northfield IC. Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. Steering committee.

    Google Scholar 

  11. Blatchford O Davidson LA Murray WR, et al. Acute upper gastrointestinal haemorrhage in west of Scotland: case ascertainment study. Brit Med J. 1997;315:510–514.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Website http://www.patient.co.uk/showdoc/40000851.

  13. Borum M. Peptic ulcer in the elderly. Clin Geriatr Med. 1999;15(3):457–7.

    CAS  PubMed  Google Scholar 

  14. Pilotto A, Leandro G, DiMario F, Fannceschi M, Bozzola L, Valerio G. Role of Helicobacter pylori infection on upper gastrointestinal bleeding in the elderly. Digestive Disease and Sciences. 1997;42:586–591.

    Article  CAS  Google Scholar 

  15. Fintch PG. Colonic angiodysplasia. Gastroenterologist. 1997;5 (2):148–56. Review.

    Google Scholar 

  16. Descamp C, Schmidt A, Van Gossin A. ‘Missed’ upper gastrointestinal tract lesions explain ‘occult’ bleeding. Endoscopy. 1999;31:4525.

    Google Scholar 

  17. Chiu ML, Liu GC, Lui CS, Chew CY. Angiodysplasia mimicking colon cancer, colonoscopy, double contrast barium enema and CT findings. Am J Roentgenology. 2007;188(5):w456-w458.

    Article  Google Scholar 

  18. Bruchner HW, Morris JC, Mansfield P. Chap 95. Neoplasms of the stomach Cancer Medicine 6th edition. Ed Donald W Kute, Raphael E Pollock, Ralph L Weichselbaum, Robert C Bast Jr, Ted S Gansser, James F Hollard, Emil Frei M. 2003.

    Google Scholar 

  19. Rios A, Montoya M, Rodriquez JM, Serrano A, Molina J, Parrilla P. Acute lower gastrointestinal haemorrhages in geriatric patients. Dig Dis Soc. 2005; 56:890–904.

    Google Scholar 

  20. Lakatos L, Lakatos PL. Colonic diverticular disease, diagnosis and therapy. Orv Hetil. 2012;153(6):205–13.

    Article  PubMed  Google Scholar 

  21. Maier KP. Diverticuosis and diverticulitis. Praxis (Bern,1994). 2007;96(5):153–7.

    Article  CAS  Google Scholar 

  22. Painter NS, Burkitt HDP. Diverticular disease of the colon: A deficiency disease of Western civilization. Br Med J. 1971;72:450–3.

    Article  Google Scholar 

  23. Bogard ST. What do we know about diverticular disease? A brief overview. J Clin Gastroenterol. 2006;suppl 3 S108–11.

    Google Scholar 

  24. Korzemik JR. Case closed? Diverticulitis: epidemiology and fiber. J Clin Gastrenterol. 2006;40 Suppl 3 S112–6.

    Article  Google Scholar 

  25. Rinas V, Adamch HE. Diverticulitis and diverticulosis. MMW. Fortschr Med. 2006;148(29–30):37–41.

    Article  CAS  PubMed  Google Scholar 

  26. Kang JY, Melville D, Maxwell JD. Epidemiology and management of diverticular disease of the colon. Drugs Aging. 2004;21(4):211–28.

    Article  PubMed  Google Scholar 

  27. Compurato G, Pilotto A, Franze A, Franseschi M, Di Mario F. Diverticular disease in the elderly. Dig Dis 2007;25(2):151–4.

    Article  Google Scholar 

  28. Weizman AV, Nguyen GC. Diverticular disease: epidemiology and management. Can J Gastroenterol. 2011;25(7):385–9.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Foutch PG. Angiodysplasia of the gastrointestinal tract. Am J Gasteroenterol 1983;88:807–818.

    Google Scholar 

  30. Hemingway AP. Angiodysplasia as a cause of iron deficiency anaemia. Blood Rev. 1989;3:147–151.

    Article  CAS  PubMed  Google Scholar 

  31. Jenkinson SA, Abarracin NS Jr. Lower intestinal bleeding secondary to colonic vascular ectasia. J Am Osteopathic Ass. 1989;89:337.

    CAS  Google Scholar 

  32. Brandt LJ, Boley ST, Migsudo S. Clinical characteristics and natural history of colitis in the elderly. Am J Gastroerontol. 1982;77:382–387.

    CAS  Google Scholar 

  33. Kirsner JB, Schraeder RG. Inflammatory Bowel Disease. Philadelphia, Lea and Ferberger 1980. pp 13–15.

    Google Scholar 

  34. Mosele M, Cardin F, Inelmen EM, Coin A, Perissinotto E, Sergi G, et al. Ischaemic colitis in the elderly predictions of the disease and prognostic factors to negative outcome. Scand J Gastroenterol. 2010;45(4):428–433.

    Article  PubMed  Google Scholar 

  35. Stunell H, Buckley O, Lyburn ID, McGann G, Fsrell M, Torreggiani WC. The role of computerised tomography in the evaluation of gastrointestinal bleeding following negative or failed endoscopy: a review of current status. J Postgrad Med. 2008;54(2):126–34.

    Article  CAS  PubMed  Google Scholar 

  36. Barnert J, Messmann H. Diagnosis and management of lower gastrointestinal bleeding. Nat Rev Gastroenterol Hepatol. 2009;6(11):637–46.

    Article  PubMed  Google Scholar 

  37. Patient. Upper Gastrointestinal bleeding(including Rockall score). Patient.info/doctr/upper-gastrointestinal –bleeding-including-rockall-score. Accessed 30 June 2016.

  38. Rockall TA, Logan RF, Devlin HB, Northfield TC. Risk assessment after acute gastrointestinal haemorrhage Gut. 1996;38:316–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Website http://www.ccspublishing.com/journals2a/upper_gastrointestinal_bleeding htm

  40. Jensen DM, Machdacado GA. Colonoscopy for the diagnosis and treatment of severe lower gastrointestinal bleeding. Gastrointest Endosc. Clin N Am. 1997;7:477–98.

    CAS  PubMed  Google Scholar 

  41. Zuckerman GR, Prakash C. Acute lower intestinal bleeding. Part 1. Clinical presentation and diagnosis. Gastrointest Endosc. 1998;48:606–610.

    Article  CAS  PubMed  Google Scholar 

  42. Rockey DC. Occult and obscure gastrointestinal bleeding: causes and clinical management. Nat Rev Gastroenterol Hepatol. 2010;7(5):265–79.

    Article  PubMed  Google Scholar 

  43. Bull-Henry K, Al-Kawas FH. Evaluation of occult gastrointestinal bleeding. Am Fam Physician.2013; 87(6):430–6.

    PubMed  Google Scholar 

  44. Mitchell SH, Schaefer DC, Dubagunta S. A new view of occult and obscure gastrointestinal bleeding. Am Fam Physician. 2004;69(4):875–81.

    PubMed  Google Scholar 

  45. Guidelines for non-variceal upper gastrointestinal haemorrhage. British Society of Gastroenterology. 2002.

    Google Scholar 

  46. Peter DJ, Dougherty JM. Evaluation of the patient with gastrointestinal bleeding: an evidence based approach. Emerg Med Clin North Am. 1999;17(1):239–61.

    Article  CAS  PubMed  Google Scholar 

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Nagaratnam, N., Nagaratnam, K., Cheuk, G. (2018). Gastrointestinal Bleeding in the Elderly. In: Geriatric Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-33434-9_19

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  • DOI: https://doi.org/10.1007/978-3-319-33434-9_19

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33433-2

  • Online ISBN: 978-3-319-33434-9

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