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Gastrointestinal bleeding in stroke

E F Wijdicks1, J R Fulgham, K P Batts

  • 1Department of Neurology, Saint Marys Hospital, Mayo Clinic, Rochester, Minn. 55905.

Stroke
|November 1, 1994
PubMed
Summary
This summary is machine-generated.

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Gastrointestinal bleeding after stroke is uncommon and rarely fatal. Many cases are linked to medications like NSAIDs or anticoagulants, not stress ulcers.

Area of Science:

  • Neurology
  • Gastroenterology
  • Internal Medicine

Background:

  • Stroke patients face systemic complications, including gastrointestinal bleeding.
  • The exact causes of gastrointestinal hemorrhage post-stroke remain unclear.
  • Previous assumptions linked this bleeding to stress ulcers without specific investigation.

Purpose of the Study:

  • To investigate the causes of gastrointestinal bleeding in patients following ischemic or hemorrhagic stroke.
  • To identify associated factors and outcomes of gastrointestinal hemorrhage in stroke survivors.

Main Methods:

  • Retrospective review of 17 patients with gastrointestinal hemorrhage and stroke (1976-1994).
  • Analysis of patient presentation, associated causes, and outcomes.
  • Compilation of endoscopic findings and review of gastric biopsies.

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Main Results:

  • Common presentations included hematemesis, decreased hemoglobin, and orthostatic hypotension.
  • Endoscopic findings revealed erosions, gastritis, and ulcers; one gastric adenocarcinoma was noted.
  • Identified causes included nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, anticoagulation, and Helicobacter pylori.

Conclusions:

  • Gastrointestinal bleeding after stroke is typically not severe and has minimal impact on mortality.
  • Medication-induced gastrointestinal hemorrhage is a significant, potentially underappreciated, factor in stroke patients.