vitamin-b-12 and Gastrointestinal-Hemorrhage

Topics: Antigens, Bacterial; Antilymphocyte Serum; Bile Acids and Salts; Celiac Disease; Chronic Disease; Colectomy; Colitis, Ulcerative; Crohn Disease; Cytotoxicity Tests, Immunologic; Diarrhea; Digestive System; Escherichia coli; Gastrointestinal Hemorrhage; Glutens; Humans; Ileostomy; Immune Sera; Lymphocytes; Malabsorption Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

Topics: ABO Blood-Group System; Celiac Disease; Chronic Disease; Colitis, Ulcerative; Crohn Disease; Drainage; Esophageal Diseases; Female; Folic Acid; Gastrectomy; Gastritis; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Heavy Chain Disease; Hepatitis, Viral, Human; Humans; Hypersplenism; Intestinal Diseases; Iron; Liver Diseases; Middle Aged; Pancreatic Diseases; Vagotomy; Vitamin B 12

Patients treated in a randomized controlled comparison of management of benign gastric ulcer of the body of the stomach, comprising 50 patients treated by Billroth I partial gastrectomy and 50 patients treated by vagotomy and pyloroplasty and biopsy of the ulcer, were followed up for about five years (range one and a half to eight and a half years). No statistically significant difference has been found between the functional results (Visick grading) of the two groups. There was no operative mortality. Postoperative morbidity (17 against 5) and length of stay in hospital (14 against 10 days) were significantly greater after gastrectomy. Seven patients after vagotomy have been submitted to gastrectomy (three for recurrent gastric ulceration, three for gastric cancer, and one for bleeding), which is a statistically significant excess compared with no reoperation after gastrectomy. While vagotomy and pyloroplasty can be useful to avoid a technically difficult gastrectomy, it cannot be said to replace partial gastrectomy in the treatment of gastric ulcer.

Topics: Clinical Trials as Topic; Folic Acid; Follow-Up Studies; Gastrectomy; Gastrointestinal Hemorrhage; Hemoglobinometry; Humans; Iron; Length of Stay; Postoperative Complications; Pylorus; Recurrence; Stomach Diseases; Stomach Neoplasms; Stomach Ulcer; Vagotomy; Vitamin B 12

A 62-year-old woman was referred to Gastroenterology appointment due to severe iron deficiency anemia (5.9 g/dL), complaining of asthenia and requiring blood transfusion. The patient denied blood loss. Initial blood test showed a severe iron deficiency, with ferritin of 5ng/mL and transferrin saturation of 2.7%. Folic acid and vitamin B12 were normal. Upper gastroscopy and colonoscopy didn't show any lesions. Abdominopelvic CT and capsule endoscopy were, also, normal.

Topics: Anemia, Iron-Deficiency; Colonoscopy; Endoscopy, Gastrointestinal; Female; Gastrointestinal Hemorrhage; Gastroscopy; Humans; Middle Aged; Vitamin B 12

Topics: Aged; Anemia; Erythrocyte Volume; Erythrocytes, Abnormal; Female; Ferric Compounds; Gastrointestinal Hemorrhage; Hemoglobins; Hemorrhoids; Humans; Infusions, Intravenous; Leucovorin; Maltose; Rectum; Reticulocyte Count; Vitamin B 12

Folate-deficiency anaemia occurs in about 4 per 100 000 people, although severe cases causing moderate pancytopenia are rarer. We present the case of a significant folate deficiency in a 50-year-old alcoholic with a background of mild liver impairment and recurrent nasal and rectal bleeding. Her blood tests showed profound macrocytic anaemia with haemoglobin 2.6 g/dl, leucopoenia with white cell count 3.2 × 10(9)/litre and thrombocytopenia with platelets 17 × 10(9)/litre. Serum folate was 0.8 ng/ml (normal 2.5-13.5 ng/ml) confirming severe deficiency. Despite these life-threatening results, the patient was stable, alert and was keen to avoid admission. Medical management of the anaemia included slow transfusion of red cells and one unit of platelets in view of haemorrhagic symptoms, two injections of vitamin B12 while awaiting assays and oral folic acid. A rapid improvement in the leucopoenia and thrombocytopenia resulted and no additional complications were encountered.

Topics: Anemia, Macrocytic; Combined Modality Therapy; Epistaxis; Erythrocyte Transfusion; Female; Folic Acid; Folic Acid Deficiency; Gastrointestinal Hemorrhage; Humans; Leukopenia; Liver Diseases, Alcoholic; Middle Aged; Pancytopenia; Platelet Transfusion; Thrombocytopenia; Vitamin B 12

We report a case of Crohn's disease in a 32-year old Saudi male. The disease presented with severe, life-threatening ileal bleeding necessitating an urgent laparotomy and 100 cm of ileum and ascending colon was resected. The bleeding source was several ulcers in an inflamed ileum and histopathologic examination revealed typical findings of Crohn's disease with a chronic, transmural inflammation, non-caseating granuloma and the Ziehl-Neelsen stain was negative. The postoperative course was uneventful. On follow-up he is doing well on medical treatment with mesalamine and substitution therapy with vitamin B12.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Biopsy; Colectomy; Colonic Diseases; Critical Illness; Crohn Disease; Gastrointestinal Hemorrhage; Humans; Ileal Diseases; Male; Mesalamine; Shock; Vitamin B 12

Topics: Aged; Duodenal Diseases; Erythropoietin; Female; Folic Acid; Gastrointestinal Hemorrhage; Histamine H2 Antagonists; Humans; Male; Recombinant Proteins; Renal Dialysis; Stomach Diseases; Treatment Refusal; Vitamin B 12

Topics: Aftercare; Dumping Syndrome; Esophagitis, Peptic; Folic Acid; Gastrectomy; Gastritis; Gastrointestinal Hemorrhage; Gastroscopy; Humans; Iron; Neoplasm Recurrence, Local; Nutritional Requirements; Vitamin B 12

Topics: Aged; Aging; Alcoholism; Anemia; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Animals; Blood Cell Count; Drug-Related Side Effects and Adverse Reactions; Female; Ferrous Compounds; Folic Acid; Folic Acid Deficiency; Gastrointestinal Hemorrhage; Humans; Male; Mice; Reference Values; Vitamin B 12

The facts known today about the occurrence and possible mechanisms of anaemias caused by medicaments are represented in a survey. In this connection toxic haemolytic anaemias, immunohaemolytic anaemias, toxic aplastic anaemias, megaloblastic anaemias, and some other, more rarely occurring types are referred to.

Topics: Alcoholism; Anemia; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hemolytic, Autoimmune; Anemia, Megaloblastic; Anemia, Sideroblastic; Antitubercular Agents; Benzenesulfonates; Bone Marrow; Chloramphenicol; Chromosome Aberrations; Contraceptives, Oral, Hormonal; Folic Acid Antagonists; Gastrointestinal Hemorrhage; Humans; Preleukemia; Purines; Pyrimidines; Vitamin B 12

The prevalence and causes of anemia have been studied in 104 patients over 60 years of age admitted to a general medical ward in Jerusalem. In males and females, mean hemoglobin levels were about 1 g less than in the corresponding groups of healthy younger controls. A primary nutritional anemia could not be implicated in any of the 15 patients with hemoglobins below 11 g/dl. The most important causes of anemia were chronic renal failure, metastatic carcinoma, gastrointestinal bleeding, and infection. Conversely, in diseases with no adverse effect on erythropoiesis such as chronic ischemic heart disease, hypertension and diabetes, hemoglobin levels were equal to those of the younger controls. These findings indicate that although diminished serum iron and RBC folate levels may occasionally be found in elderly subjects, nutritional deficiency is seldom responsible for anemia in this age group in Israel- and anemia when present is often the manifestation of a chronic underlying disease.

Topics: Adult; Aged; Anemia; Female; Folic Acid; Gastrointestinal Hemorrhage; Hemoglobins; Hospitalization; Humans; Infections; Iron; Iron Deficiencies; Israel; Kidney Diseases; Male; Middle Aged; Vitamin B 12

Rats with surgically created self-filling jejunal blind loops and the blind loop syndrome manifested gastrointestinal bleeding and hyperabsorption of iron. Although the mean hematocrit and serum iron levels of rats with self-filling blind loops became overtly anemic and manifested low-serum iron levels. It is suggested that the documented gastrointestinal bleeding in these rats with the experimental blind loop syndrome is another manifestation of damage to the intestinal epithelium in conditions of small intestinal bacterial overgrowth.

Topics: Animals; Blind Loop Syndrome; Digestive System Physiological Phenomena; Disease Models, Animal; Feces; Gastrointestinal Hemorrhage; Guaiac; Hematocrit; Intestinal Absorption; Iron; Male; Occult Blood; Rats; Vitamin B 12

New tests and test methods aid in the diagnosis of pancreatic disorders. Pancreatic carcinoma, especially, may have an improved prognosis with earlier detection as a result of refinements in arteriography, cytology, pancreatic radioisotopic scanning, and endoscopic retrograde cholangiopancreatography. Acute pancreatitis results most commonly from alcoholism, biliary tract disease, and trauma. Management is directed primarily at decreasing pancreatic exocrine secretion. Surgery is usually best avoided in the acute phase. Chronic pancreatitis is most often a result of recurrent attacks of acute pancreatitis. Diabetes and malassimilation become manifest as pancreatic destruction progresses. Management consists of replacement of pancreatic enzymes and diet supplements. Once chronic pancreatitis is established, surgery can only be directed at complications of the disease. Pancreatic ascites is usually associated with a break in the pancreatic ductal system. Ascites caused by trauma responds well to surgical intervention, but the alcoholic type is less amenable to treatment.

Topics: Acute Disease; Alcoholism; Antacids; Ascites; Carcinoembryonic Antigen; Cholangiography; Chronic Disease; Cysts; Diabetes Mellitus; Diet Therapy; Endoscopy; Gastrointestinal Hemorrhage; Humans; Metabolic Diseases; Methionine; Pancreatic Diseases; Pancreatic Juice; Pancreatic Neoplasms; Pancreatin; Pancreatitis; Prognosis; Selenium; Ultrasonics; Vitamin B 12

Topics: Acidosis; Adult; Cyanides; Cyanosis; Gastric Lavage; Gastrointestinal Hemorrhage; Humans; Hydrogen Cyanide; Hydrogen-Ion Concentration; Hydroxocobalamin; Hypotension; Liver; Middle Aged; Poisoning; Suicide; Time Factors; Vitamin B 12

Topics: Adult; Anemia; Biopsy; Blind Loop Syndrome; Chronic Disease; Diarrhea; Gastrointestinal Hemorrhage; Humans; Intestinal Absorption; Intestinal Mucosa; Malabsorption Syndromes; Male; Radiography; Ulcer; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia, Hypochromic; Chromium Isotopes; Cobalt Isotopes; Female; Folic Acid; Gastrointestinal Hemorrhage; Hookworm Infections; Humans; Intestinal Absorption; Iron; Iron Isotopes; Male; Middle Aged; Parasite Egg Count; Serum Albumin; Tritium; Vitamin B 12

Topics: Animals; Blood Cell Count; Copper; Cortisone; Gastrointestinal Hemorrhage; Histamine H1 Antagonists; Hypersensitivity; Intestine, Small; Kidney; Liver; Promethazine; Swine; Swine Diseases; Vitamin B 12

The effect of aspirin (acetylsalicylic acid) ingestion on occult gastrointestinal blood loss has been studied in patients with treated Addisonian pernicious anaemia and proved achlorhydria and in control patients able to secrete hydrochloric acid. A highly significant increase in gastrointestinal blood loss (1.9 ml./day of treatment) occurred with aspirin ingestion in the achlorhydric patients. The control group had a significantly greater increase in blood loss (4.29 ml./day of treatment). Thus aspirin can produce occult gastrointestinal blood loss by a mechanism unrelated to hydrochloric acid. Half of the control patients had losses of similar magnitude to those in the pernicious anaemia group, and the degree of blood loss in individual control patients appeared unrelated to gastric acidity. Differences in gastric mucosal characteristics, in the rate of gastric emptying, or in systemic effects of aspirin may explain the variation between individuals in the degree of occult gastrointestinal blood loss after aspirin.

Topics: Achlorhydria; Adult; Aged; Anemia, Pernicious; Aspirin; Bone Marrow Examination; Female; Fluorescent Antibody Technique; Folic Acid; Gastric Juice; Gastric Mucosa; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Occult Blood; Vitamin B 12

Topics: Adolescent; Adrenal Cortex Hormones; Anemia; Child; Child, Preschool; Diagnosis, Differential; Female; Gastrointestinal Hemorrhage; Hematocrit; Hemoglobins; Humans; Infant; Infant, Newborn; Iron; Male; Testosterone; Vitamin B 12

Topics: Adult; Aged; Alkaline Phosphatase; Female; Gastrointestinal Hemorrhage; Histamine H1 Antagonists; Humans; Isoenzymes; L-Lactate Dehydrogenase; Male; Middle Aged; Prostatic Neoplasms; Urinary Bladder Neoplasms; Vitamin B 12

Topics: Adult; Age Factors; Aged; Alkaline Phosphatase; Body Weight; Calcium; Duodenal Ulcer; Female; Follow-Up Studies; Gastrointestinal Hemorrhage; Hemoglobinometry; Humans; Iron; Male; Mental Disorders; Middle Aged; Phosphates; Statistics as Topic; Vitamin B 12

Topics: Aged; Anemia, Hypochromic; Chromium Isotopes; Feces; Female; Gastrointestinal Hemorrhage; Gastroscopy; Hemoglobinometry; Humans; Iron; Male; Middle Aged; Postgastrectomy Syndromes; Vitamin B 12

Topics: Adult; Amebiasis; Anemia, Pernicious; Gastrointestinal Hemorrhage; Humans; Iron-Dextran Complex; Malabsorption Syndromes; Male; Spinal Cord Diseases; Vitamin B 12

Topics: Alcoholism; Anemia; Anemia, Hypochromic; Avitaminosis; Cholestyramine Resin; Common Bile Duct; Diet; Diet Therapy; Diuretics; Folic Acid; Folic Acid Deficiency; Gastrointestinal Hemorrhage; Humans; Hydrochlorothiazide; Ion Exchange Resins; Jaundice; Liver Cirrhosis; Liver Cirrhosis, Biliary; Postoperative Complications; Prothrombin Time; Vitamin B 12; Vitamin B Complex; Vitamin K

Topics: Anemia; Anemia, Hypochromic; Blood Sedimentation; Chromium Isotopes; Colitis, Ulcerative; Feces; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Iron; Iron Isotopes; Occult Blood; Radioisotopes; Radionuclide Imaging; Vitamin B 12