Hematemesis: what are we talking about exactly?
A little etymology. In ancient Greek, the prefix "hema-" (or "hemo-" as in "hemorrhage") refers to blood while "emesis" refers to the act of vomiting (as in "anti-emetic drugs"). We therefore speak of hematemesis to designate the act of vomiting blood.
" A person with hematemesis will vomit the contents of their stomach and blood, or only blood mixed with fluid "specifies Prof. Frank Zerbib, gastroenterologist and hepatologist.
To know. Be careful not to confuse hematemesis with hemoptysis: in case of hematemesis, there is bloody vomiting (it comes from the digestive system) while in case of hemoptysis, the person spits blood (it comes from lungs). Hematemesis is the responsibility of the gastroenterologist doctor while hemoptysis concerns the pulmonologist doctor.
Hematemesis: what can be the causes?
To know. " Hematemesis, or the act of vomiting blood, indicates the presence of lesions in the upper part of the digestive tract: the esophagus, stomach or duodenum "underlines Prof. Zerbib. The esophagus is the flexible" pipe "which connects the throat to the stomach; the duodenum is the first segment of the small intestine which is located just after the stomach in the digestive system.
What can be the causes of hematemesis?
- An ulcer. An ulcer of the stomach, the esophagus or the duodenum can be responsible for a hematemesis: indeed, by dint of "digging" in the digestive wall, the ulcer can reach a blood vessel and trigger a digestive bleeding, responsible for bloody vomiting (hematemesis).
- Esophageal varices. " It is a common cause that is more common in people with cirrhosis of the liver, alcoholic or not "specifies the gastroenterologist. In fact: cirrhosis of the liver (associated with portal hypertension) causes the veins of the esophagus to become engorged. They sometimes dilate until they rupture – there is then an esophageal bleeding which results in hematemesis.
- A stomach tumor. A stomach tumor (benign or malignant, in the case of stomach cancer for example) may be responsible for gastric bleeding and associated hematemesis.
- An angioma. It is an intertwining of small blood vessels (usually located in the liver in the digestive system) resulting from a congenital malformation. Normally mild, angioma can cause hematemesis.
Hematemesis: I vomit blood, what should I do?
Warning ! " Even a small, even occasional hematemesis is always a medical emergency – and even more if it occurs in a person suffering from a hepatic pathology (alcoholic cirrhosis of the liver or not hepatitis…), warns Professor Zerbib. From the first bloody vomiting, it is essential to go to the hospital as soon as possible! "It should be noted that hematemesis can also occur in children, adolescents and pregnant women.
Hematemesis: what are the medical exams? In the event of hematemesis, several medical examinations intended to evaluate the extent of the haemorrhage will be carried out in the hospital: a blood pressure measurement and a measurement of the hemoglobin level in the blood, in particular. " These measures will notably indicate to the nursing staff if the patient requires a blood transfusion "explains the gastroenterologist.
Then doctors can request a endoscopy : this medical examination (which usually takes place under general anesthesia in the context of hematemesis) consists of bringing a small camera down into the digestive system via the mouth using a tube to observe the esophagus, stomach and the duodenum and thus identify the origin of the bleeding.
To know. " Hematemesis can be accompanied by black stools: the blood which is rejected via vomiting is red because it has not had time to oxidize and to be digested. However, part of the blood emitted in the upper part of the digestive tract can be evacuated by the stool: under the effect of oxidation and digestion, these are black and liquid like tar "adds Prof. Frank Zerbib.
Hematemesis: which treatments? " The management of hematemesis depends of course on its cause: for example, if it is a question of esophageal varices, a ligature by endoscopy could be considered ", explains Professor Zerbib.
Thanks to Prof. Frank Zerbib, gastroenterologist and hepatologist, member of the French National Society of Gastroenterology (SNFGE).
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