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History of operation for bleeding ulcer. Low Hb value. Need guidance

hi my dad has a bleeding ulcer since the last 12 years. He was operated back n 1978 for ulcers . Since 1999-2000 his ulcers have statrted to bleed. we visited Asian Institute, Hyd(Dr. nageshwar Reddy) n he sealed the ulcer but the problem recurrs every 2-3 years. as a result his Hb value goes down. It is 4 nw n he is getting BT as I write this mail. Please guide.
Asked On : Thu, 27 Dec 2012
Answers:  2 Views:  16
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General Surgeon 's  Response

Thank you for the query.

With digestive tract bleeding usually it is necessary to start with upper GI endoscopy (with present black stools or vomiting with blood). The next step is colonoscopy. If still bleeding can not be localized, angio-CT whouls be performed. Depending of the source of bleeding proper treatment should be done.
If peptic ulcer is bleeding and this can be stopped with endoscopy, surgery is necessary and partial stomach removal might be necessary as well. Also Omeprasole 120 mg /24 hours should be injected. Helicobacter Pylori eradication is also necessary.
If the bleeding is from large intestine (usually colon cancer), there is no other way to treat it than surgery. Same is with small intestine malformation.

Hope this will help.
Answered: Fri, 28 Dec 2012
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Internal Medicine Specialist Dr. Enrique Molina's  Response
Hi, I will be happy to assist you. The fact that he has recurrent ulcers needs to be further investigated. First of all the type of surgery he had back in the 70s can predispose him to new ulceration at the "anastomosis" site (the place where they stitched the bowel back together). He needs to be checked for Helicobacter pylori infection and treated if he is positive. Make sure he is not taking any NSAIDs inadvertently (aspirin, ibuprofen, naproxen, etc). He can also be checked for rarer causes of recurrent ulcers such as Gastrinoma (ask your doctor to check for it with a blood test: a gastrin level can be measured).
He should probably be on a PPI medication in the meantime (such as omeprazole).
While he is in the hospital he will probably get an endoscopy and blood transfusions.
Answered: Fri, 28 Dec 2012
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