ABSTRACT
Pathophysiology is briefly described, but discussion focuses on nursing interventions. Underlying causes of these conditions may be chronic, possibly necessitating later medical or surgical treatments, but this chapter focuses on acute care. Once immediate dangers to life have been removed, care and treatment increasingly focuses on causes, underlying problems and needs. The gut is highly vascular, so susceptible to major bleeds. Upper gastrointestinal bleeds from
n oesophageal varices or n ulcers (gastric or duodenal)
may develop rapidly, prove fatal, and are the most common gastrointestinal emergency (British Society of Gastroenterology Endoscopy Committee, 2000). Shock and other signs are often present (see Box 31.1). Priority should therefore be given to restoring circulating volume, and stopping haemorrhage. Bleeds in the lower gut are usually from chronic conditions. They can be lifethreatening, requiring major surgery or aggressive medical treatment, but are less likely to necessitate emergency admission. Lower GI bleeds are briefly discussed, together with bowel care.
