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Gastrointestinal tract bleeding in intellectually disabled adults
Kamran Khalid1, Saleh M Al-Salamah, Ibrahim Al-Teimi
1College of Medicine, and Department of General Surgery Medicine, King Saud University Unit, Riyadh Medical Complex, Riyadh, Saudi Arabia. kkkhawaja@rcsed.ac.uk
Southern Medical Journal
|January 8, 2008
Summary
Gastrointestinal bleeding in adults with intellectual disability (ID) is challenging. Reflux esophagitis is the most frequent cause of upper GI bleeding in this population.
Area of Science:
- Gastroenterology
- Internal Medicine
- Disability Studies
Background:
- Gastrointestinal (GI) bleeding in individuals with intellectual disability (ID) presents unique diagnostic and management challenges.
- This study reviews the experience of a tertiary referral hospital in Central Saudi Arabia managing GI bleeding admissions in adults with ID.
Purpose of the Study:
- To detail the diagnostic and management experiences of GI bleeding in intellectually disabled adults.
- To analyze demographic, clinical, etiological, and outcome data for these patients.
Main Methods:
- Prospective data collection on consecutive intellectually disabled adults admitted for GI bleeding (January 2000 - December 2004).
- Analysis of demographic details, clinical presentation, diagnosis, associated disabilities, bleeding etiology, and treatment outcomes.
Main Results:
- Thirty-nine intellectually disabled adults accounted for 44 admissions.
- Upper GI bleeding (66.7%) was more common than lower GI bleeding (33.3%).
- Reflux esophagitis was the most common cause of upper GI bleeding (57.7%); congenital anomalies were associated with lower GI bleeding.
Conclusions:
- Bleeding gastroesophageal reflux disease (GERD) is the primary cause of upper GI bleeding requiring admission in ID patients.
- Endoscopy is crucial for diagnosis and initial management; surveillance endoscopy is recommended for Barrett's changes.
- Bleeding from developmental malformations may be linked to intellectual disability.
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