The use of NSAID has been associated with increased risks of gastrointestinal bleeding in unselected patients, approximately five-fold for musculoskeletal pain and two fold for secondary prevention of cardiovascular disease with low-dose aspirin (Clinical Guideline 17: Dyspepsia 2004). Therefore, depending on the level of pain management required, a simple analgesic that can be used for pain management is paracetamol; this preparation does not cause bleeding of the stomach and it has been found to be highly effective in relieving mild to moderate pain; furthermore, it can be purchased without a prescription from chemists and supermarkets (Henderson & Wood 2000).
Discussion of Health Education Advice Required.
The U.K. Department of Health recommends the following educational advice and support for people suffering from gastrointestinal bleeding:
Patients and their relatives should be offered as much information as they want. GPs should ask what they would like to know, and give unambiguous answers to their questions.
Information should be clear, full, and prompt, and should be available in both verbal and written forms. It should include information about the disease, diagnostic procedures, the aims and anticipated benefits of treatment, and realistic estimates both of the probability of success and potential adverse effects.
Specialist guidance should be available for patients from a dietitian, to advise on nutrition and minimising problems with eating, and to help those who have undergone resection to cope with post-surgical syndromes.
Many patients and carers will require both practical and social support; they should be given information about sources of help, such as local and national support groups and disability and benefits helplines.
Psychological interventions such as counselling should be offered to patients who are anxious, depressed, or who have particular difficulty coping (Improving Outcomes in Upper Gastro-intestinal Cancers, 2006).
Analysis of the Nurse's Role within the Multidisciplinary Team.
According to "Improving Outcomes in Upper Gastro-intestinal Cancers" (2006), the following factors will influence the nurse's role within the multidisciplinary healthcare team for the treatment of gastrorrhagia:
There should be clear documented policies for referral of patients between hospitals, and for processes by which clinicians in local hospitals seek advice from specialist treatment teams about the management of individual patients for whom referral may not be appropriate; and,
Palliative support and specialist care should be available to all who need it. This will require effective co-ordination and communication between primary care, social and voluntary services, local palliative care teams, hospital services and for those healthcare practitioners that provide specialist advice and interventions.
Finally, if there is alcohol use involved, it is important for the nursing staff to help educate the patient and caregivers concerning the need to stop. In fact, the survival rate is only 60% for those who stop drinking and 35% for those who do not in cases of gastro-intestinal bleeding (Govini et al. 2003).
The research showed that gastrorrhagia is an umbrella term used to refer to a hemorrhage or bleeding in the stomach. While the condition can be caused by a variety of maladies, the most common cause for bleeding in the upper gastrointestinal tract is a peptic ulcer. The research also showed that various diagnostic and treatment interventions exist will proven efficacy, and these are generally delivered along a continuum of increasingly invasive procedures until a satisfactory intervention has been achieved. Careful monitoring of patients suffering from gastrorrhagia was also shown to be an essential component of effective care, and nurses can play an important role in both the inpatient and outpatient setting by helping the patient and his or her caregivers recognize the potential severity of the condition and to make the healthy dietary and lifestyle choices they will need to make to avoid a recurrence of the bleeding or hemorrhaging.
Barve, S., Hill, D., Marsano, L.L., Mcclain, C.J., & Mendez, C. (2003). "Diagnosis and Treatment of Alcoholic Liver Disease and Its Complications." Alcohol Research & Health 27(3):247.
Dyspepsia: Management of dyspepsia in adults in primary care. NICE Clinical Guideline 17. [Online]. Available: http://www.nice.org.uk/guidance/CG17/niceguidance/word/English.