Self assessment of warning symptoms in upper gastrointestinal bleeding

Alcohol addicted patients are at increased risk of upper gastrointestinal bleeding. Delay to endoscopy is mainly determined by patients' self assessment.

The authors asked 417 patients with high alcohol consumption from Leipzig (n = 277) and Munich (n = 140) with an average alcohol consumption of 660 g/week about their behavior when faced with symptoms of acute upper gastrointestinal bleeding.

71% or 51% said they would call the emergency physician if they were to vomit blood or black liquid. Only 32% would call emergency medical aid if they were to pass black stools, and only 25% of those surveyed thought urgent medical attention necessary in any of the three scenarios. Patients with regular contact with health care providers, and women, were more likely to consider these three scenarios as medical emergencies. The authors found no differences by age, educational level, marital status and alcohol consumption.

Knowledge concerning the impact of symptoms of gastrointestinal bleeding was poor, in our study. Patients with high alcohol consumption and infrequent contact with health care providers, in particular, should be informed about symptoms such as melena and hematemesis, as delayed presentation significantly affects prognosis and resource consumption.