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Introduction: Acute gastrointestinal (GI) bleeding is a lifethreatening emergency that remains a common cause ofhospitalization worldwide. The aetiology of acute uppergastrointestinal bleed (UGIB) varies with each geographicalregion. Study aimed to analyse clinical profile, endoscopicprofile and in-hospital mortality in patients with acute uppergastrointestinal bleeding.Material and methods: This was a retrospective analysisconducted in a Tertiary care centre in Bangalore. In this studywe analysed the records of consecutive patients admitted withUpper Gastro-Intestinal bleeding over period of three yearsfrom January 2016 till January 2019.Results: We analysed two thirty consecutive patientsdiagnosed with acute upper gastrointestinal bleeding, 77.4%patients were males and 22.6% were females, mean age ofpresentation was 49.10 years. Most of the patients, oneseventy-three (75%) were between the age group of 31-70 years. Melena was the most common symptom 80.4%followed by hematemesis 47%. History of chronic alcoholintake was noted in ninety three (40.4%) and smoking in sixtyfive (28.3%), medication history depicted that sixteen (6.92%)patients were on NSAIDS; fifteen (6.49%) patients were onanti-platelet drugs, five (2.1%) patients were on steroids, one(0.4%) patient was on Newer Oral Anti Coagulants.Conclusion: The present study reported peptic ulcer diseaseas the most common cause of upper GI bleeding, followedby portal hypertension related bleeding. The most commonendoscopic lesions reported were esophageal varices,followed by duodenal ulcer. Upper G.I endoscopy is animportant modality in both diagnosis and therapy in upperG.I bleed, concomitant medical and Endoscopic therapy mayreduce mortality, morbidity and also the need for surgery/interventional radiology assisted haemostasis.
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Primary amyloidosis is a group of monoclonal plasma cell disorders, characterized by extracellular deposition of immunoglobulin light chain fibrils in multiple organs leading to progressive multiorgan dysfunction. It is a rare disease which usually occurs in elderly persons and has a poor prognosis. We report a 72-year-old male patient with chronic abdominal distension, bilateral pitting pedal edema with nephrotic range proteinuria and amyloid deposition in liver and bone marrow. Immunoelectrophoresis of serum demonstrated the presence of immunoglobulin light chains of the circulating monoclonal protein. He was treated with IV bortezomib and IV dexamethasone.
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The exact cause of irritable bowel syndrome (IBS) is not known. Multiple factors, like genetic, gut motility, visceral hypersensitivity, psychosocial factors and immune-mediated factors, are thought to contribute to the symptom complex of IBS. Till date an ‘IBS gene’ has not been defined, and there is a need for further studies. The concept that IBS as a diagnosis of exclusion is not acceptable any more. The treatment of IBS is targeted at the management of constipation, diarrhoea and abdominal pain and includes pharmacotherapy with tegaserod, alosetron and lubiprostone. Cognitive behavioral therapy is very beneficial.