Stephen J. Schueler, M.D.

Overview Risk Factors Symptoms Evaluation Treatment questions for doctor specialist Home Care diarrhea in adults diarrhea in children taking control vomiting warning signs Prevention Outlook Complications Underlying Cause Anatomy

Bleeding Gastrointestinal Home Care

Home care for gastrointestinal bleeding includes:

Bleeding Gastrointestinal Diarrhea in Adults

Home treatment of diarrhea in adults with gastrointestinal bleeding includes hydration and dietary therapy.

Those who are able to drink liquids can restore lost water and salt with oral rehydration therapy (ORT).

ORT fluids are usually used in children, but are also effective for adults. These include:

  • Infalyte
  • Lytren
  • Naturalyte
  • Pedialyte
  • Rehydralyte
  • ReVital
  • Generic drugstore brands

Additional ORT fluids include:
  • Soft drinks without caffeine
  • Sports drinks (Gatorade)
  • Tea
  • Water

Dietary Therapy
ORT is most important if you have vomiting with the diarrhea. Once vomiting and nausea resolves, eat bland foods first. If you tolerate bland food, then you can resume a normal diet.

Foods that may help diarrhea:
  • Applesauce
  • Bananas
  • Bread
  • Cereal
  • Crackers
  • Mashed potatoes
  • Noodles
  • Oatmeal
  • Potatoes
  • Rice
  • Strained carrots
  • Wheat
  • Yogurt

Items that may worsen diarrhea include:
  • Alcohol
  • Caffeine
  • Concentrated fruit juices
  • High-sugar foods (junk food)
  • Cow's milk
  • Spicy foods
  • Sugar substitutes

Bleeding Gastrointestinal Diarrhea in Children

Home treatment for diarrhea in children with gastrointestinal bleeding is based on general measures and dietary therapy. Medications are rarely needed. When possible, treating the underlying cause is important.

General Measures
Simple methods can restore lost body fluids and prevent the spread of infection.

Children who are taking fluids by mouth can usually restore lost fluids and body salts with oral rehydration therapy (ORT). Simply drinking enough fluid can treat most children with diarrhea and dehydration.

ORT fluids include:

  • Infalyte
  • Lytren
  • Naturalyte
  • Pedialyte
  • Rehydralyte
  • ReVital
  • Generic drugstore brands

Older children may also use the following fluids:
  • Non-caffeinated soft drinks
  • Sports drinks
  • Tea
  • Water (not exclusively)

General Measures in Infants Under 6 Months
General measures for breast-fed infants under 6 months include:
  • Continue breast feeding as much as your baby desires.
  • Give extra feedings with an oral rehydration therapy (ORT) fluid to supplement breast milk.
  • If vomiting occurs, feed very small amounts every 30-60 minutes.
  • Prevent diaper rash by using super-absorbent diapers changed frequently and apply Vaseline or other protective ointments to the buttocks.
  • Watch for symptoms of dehydration.

General measures for bottle-fed infants under 6 months:
  • Give as much ORT fluids as often as desired.
  • Give your child as much formula as he or she will normally drink.
  • If bloating, gas or vomiting occurs, try a lactose-free formula. Formula can also be diluted in half with ORT for 1-2 days.
  • Prevent diaper rash by using super-absorbent diapers changed frequently. Apply Vaseline or other protective ointments to the buttocks.
  • Watch for symptoms of dehydration

General Measures in Children Over 6 Months
General measures for children over 6 months:

Dietary Therapy
It is not necessary to highly restrict the diet to treat diarrhea. Most children can eat a regular, balanced diet with mild or moderate diarrhea. Small, frequent meals may improve symptoms. Certain foods may help or worsen diarrhea, depending on the person.

Foods that may help diarrhea:
  • Applesauce
  • Bananas
  • Bread
  • Cereal
  • Crackers (saltines and pretzels contain needed salt)
  • Lean meats
  • Mashed potatoes
  • Noodles
  • Oatmeal
  • Oral rehydration therapy liquids
  • Potatoes
  • Rice
  • Sorghum
  • Strained carrots
  • Wheat
  • Yogurt with live cultures

Items that may worsen diarrhea include:
  • Caffeine
  • Concentrated fruit juices
  • High-sugar foods (junk food)
  • Cow's milk
  • Spicy foods
  • Sugar substitutes

Bleeding Gastrointestinal Taking Control

The successful treatment of gastrointestinal bleeding requires your participation. Here are answers to some important questions.

Do you have control over your health and wellness?
Many people believe they have no control over their health and wellness. Many ignore personal health decisions or simply leave them to their doctors, relatives, or friends. In reality, you have the greatest potential to determine your relative health.

How is this possible? Do people really have control of their own health? The biggest killers are heart disease and cancer. Although many of these diseases seem to strike at random, our lifestyle choices greatly influence personal risk.

How can you participate in your health care?
To participate you must:

  • Learn to take responsibility for your own health.
  • Learn to partner with your doctor.
  • Learn how to make active decisions about your health.

How can you learn what you need to know?
  • Educate yourself.
  • Be skeptical: Learn to separate fact from fiction.
  • Billions of dollars are spent each year marketing dietary supplements, vitamins, and new medical treatments. Much of this is unnecessary and wasteful.
  • Be careful about where you get your health information.
    • Some of the best sources for health information on the web are professional societies and non-profit organizations.
    • Ask your doctor what he or she recommends.
  • Examine the credentials of the authors.
    • If you are reading about symptoms and disease, your best source is a licensed physician.
    • Pay attention to when the content was last updated.
    • Make sure the person is not just trying to sell you something.

Important questions you need to answer:
  • What things in your control can increase your risk for disease?
  • What can you do to decrease this risk?
  • What are vaccines and how can they help you?
  • How do your lifestyle choices increase your risk for disease?
  • How can you reduce stress?
  • What minor health problems can you treat at home?
  • When is a medical problem "serious"?
  • When should you call the doctor?

How can you find the right doctor?
Key points:
  • Everyone should have a primary care physician or family doctor. A primary physician is usually a family practitioner, internist, or pediatrician.
  • Establish a relationship in advance with your doctor.
  • Make sure you are comfortable with your primary care physician.
  • The internet contains many resources where you can do research to locate the doctor that is best for you.
  • You may wish to schedule a brief visit with the doctor to see if he or she is right for you.
    • Be open-minded, and allow your doctor to know you well. This will improve communication.

Important information you need to make your decision:
  • Physician credentials:
    • Internship and residency training is usually best from respected institutions, universities, and major hospitals.
    • Look for board certification in the specialty.
    • Ask about membership in medical societies.
  • Community and professional reputation are also important.
    • Are other patients happy with the doctor?
    • Has the doctor been disciplined by hospitals or agencies?
    • How long has the doctor been in practice?
    • In general, more than a few malpractice suits over a 5-10 year period should trigger caution.
  • Does the doctor communicate well? Are your questions answered during busy times?
  • Does the doctor welcome you to help make decisions about your care?
  • Is the doctor available when you need care?
  • What is the doctor's after-hours coverage?
  • Is he or she a member of a large group?
    • Do the doctors' cross-cover one another?
  • Where do they admit patients?

What is shared decision making?
You and your doctor must work together to jointly decide the best course of action to manage your health. This process is called "shared decision making". Your doctor becomes a guide and teacher and helps steer you toward the best treatment. Most doctors welcome this partnership. You must learn about your illnesses for shared decision-making to work.

For any recommended test, medication, or surgery, remember to ask:
  • How will this help me?
  • How much will it cost?
  • Is it covered by your insurance?
  • What are the potential side effects and risks?
  • What are my alternatives?

For tests, remember to ask:
  • Is it done in the office or at another facility?
  • Is it painful?
  • How will the results of this test influence my care?

For surgery or other procedures, remember to ask:
  • How long will it take to heal?
  • How many cases has the doctor done?
  • What would your doctor do if he or she were the patient?
  • Where is it done?
  • Who will perform it?
  • What are the doctor's qualifications?

What should you expect?
Shared decision making becomes impossible if you do not know what to expect from your doctor.

The American Hospital Association has published a "Patient's Bill of Rights" that is a good guide. It states that you have the right:
  • To be spoken to in words that you understand
  • To be told what's wrong with you
  • To know the benefits of any treatment and any alternatives
  • To know what a treatment or test will cost
  • To share in treatment decisions
  • To read your medical record
  • To refuse any medical procedure

What should you do before an office visit?
  • Bring all important medical information with you to the visit.
  • Make sure you can answer questions about the following:
    • Allergies and side effects to medicines
    • Current medicines you are taking. This includes herbs and vitamins. Make a list if necessary.
    • Insurance information
    • Marital and sexual history
    • Past injuries and hospital stays
    • Past medical problems
    • Past surgeries and operations
    • Pre-visit questionnaires
    • Use of tobacco, alcohol and drugs
    • Work history

What should you expect from the visit?
  • You should plan to wait if you go without an appointment. Emergencies or sick patients in the hospital may interrupt your doctor.
  • Bring along a book or toys for the kids. You may also have to wait during busy times.
  • Tell your doctor about your problem in a clear manner. Start from the beginning and go through each symptom as it appeared.
  • Before the visit, think about what makes your problem better or worse. Your doctor will probably ask you questions about this.
  • Most doctors ask many questions about unrelated symptoms. These questions help assure that there are no other problems that need attention.
  • Be sure to answer all questions truthfully. This includes sensitive questions about smoking, drug use, sexual activity, and work. Your history is the most important part of deciding what is wrong with you.
  • If you have any difficulty communicating your concerns, bring a family member or friend to assist in this task.
  • Talk to your doctor and do not leave the office without asking necessary questions. Your doctor can make you more comfortable if he or she understands your concerns.

What should you know about your medications?
Every year many people become ill because of problems with medications.

Remember to ask:
  • What side effects to expect.
  • What drug interactions are possible.
    • Find out if a new medicine reacts with those that you are taking now.
    • Many over-the-counter drugs and dietary supplements can also cause serious side effects and drug interactions.
    • Some drugs interact with certain foods, vitamins, nicotine, and alcohol.
  • Make sure you can drive or operate machines safely while taking a medicine.
  • Ask your doctor how much a prescription costs.
    • Is there a less expensive option or a generic version?

What is a treatment plan?
A treatment plan is what you and your doctor decide to do for an illness. A treatment plan cannot be effective without your participation.

Three simple questions can help you get the most from your treatment plan:
  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do these things?

Other important points:
  • Be sure you understand your treatment plan.
  • Stick with the treatment plan and allow time for improvement.
  • Don't stop medicines when you feel better; check with your doctor first.
  • Call your doctor if your condition is becoming worse.
  • Your doctor should tell you what to expect and when to follow-up or call the office.

Bleeding Gastrointestinal Vomiting

Home care for vomiting in someone with gastrointestinal bleeding:

  • Drink clear liquids only, such as water, sports drinks, fruit juice and dilute tea. Sports drinks are best. The absence of food allows the intestines to rest.
  • Drink small quantities of fluids frequently. In general, two tablespoons of fluid every 5 minutes is an effective strategy.
  • Avoid milk and dairy products for 3 days.
  • Avoid liquids that irritate the stomach, such as citrus juice, alcohol and coffee.
  • If nausea or vomiting continues despite the above, consider one of the nonprescription medicines listed below.
  • Once vomiting and nausea resolves, start bland foods first. If you tolerate bland food, then you can resume a normal diet.

Nonprescription medications for vomiting include:

Bleeding Gastrointestinal Warning Signs

Notify your doctor if you have gastrointestinal bleeding and any of the following:

Continue to Bleeding Gastrointestinal Prevention

Last Updated: Apr 22, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Bleeding Gastrointestinal References
  1. Farrell JJ, Friedman LS. Review article: the management of lower gastrointestinal bleeding. Aliment Pharmacol Ther. 2005 Jun 1;21(11):1281-98. [15932359]
  2. Hernandez-Diaz S, Rodriguez LA. Incidence of serious upper gastrointestinal bleeding/perforation in the general population: review of epidemiologic studies. J Clin Epidemiol. 2002 Feb;55(2):157-63. [11809354]
  3. Khuroo MS, Khuroo MS, Farahat KL, Kagevi IE. Treatment with proton pump inhibitors in acute non-variceal upper gastrointestinal bleeding: a meta-analysis. J Gastroenterol Hepatol. 2005 Jan;20(1):11-25. [15610441]
  4. Lewis B, Goldfarb N. Review article: The advent of capsule endoscopy--a not-so-futuristic approach to obscure gastrointestinal bleeding. Aliment Pharmacol Ther. 2003 May 1;17(9):1085-96. [12752345]
  5. Olds GD, Cooper GS, Chak A, Sivak MV Jr, Chitale AA, Wong RC. The yield of bleeding scans in acute lower gastrointestinal hemorrhage. J Clin Gastroenterol. 2005 Apr;39(4):273-7. [15758618]
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