A unique bleeding syndrome termed as acute on chronic bleeding, associated with cirrhosis and portal hypertension, has been identified. The syndrome is characterized by typical presentation with acute bleeding (hematemesis, melena, or hematochezia) and also the presence of chronic gastrointestinal (GI) bleeding, documented as iron deficiency anemia.
The findings by a team of researchers from the Medical University of South Carolina (MUSC), Wake Forest University Medical Center, and the University of Texas Southwestern Medical Center, are published online on April 21, 2017 by the Journal of Investigative Medicine
‘Patients presenting acute on chronic bleeding should also be evaluated for associated cirrhosis and portal hypertension, for appropriate diagnosis and treatment.’
"This is recognition of a common syndrome of which practicing physicians should be aware," says Principal Investigator Don C. Rockey, M.D., first author on the article, who serves as the chair of the Department of Medicine and professor of gastroenterology at MUSC.
Of the 1,460 patients with GI bleeding involved in the study, 430 (29 percent) were found to have acute on chronic GI bleeding. The bleeding in patients with upper GI bleeding was most often a result of portal hypertensive upper GI tract pathology.
The investigators advise that clinicians confronted with patients who have acute on chronic bleeding should be aware of the association of this presentation with cirrhosis and portal hypertension for appropriate diagnosis and treatment.