Self Management after a Gastrointestinal Bleed

After you are discharged from the hospital, we want you to be as healthy and safe at home as possible. By carefully following all instructions given to you by your care team, you can help maintain and improve your own health and avoid another hospital stay.

TAKE MEDICATIONS AS DIRECTED

You are likely taking several medications to manage your condition. It is very important that you take them exactly as prescribed. Two commonly prescribed medications are:

  • Acid-reducing medications such as a proton pump inhibitor (PPI). These medications should be taken on an empty stomach, 30 minutes before eating, when possible.
  • Iron supplements. These medications should be taken with Vitamin C (ascorbic acid) tablets or orange juice to help the iron absorb in your body. Iron supplements may make your stool very dark, which is not unusual.

ATTEND YOUR SCHEDULED FOLLOW-UP APPOINTMENT(S)

After discharge from the hospital, your primary care doctor or gastroenterologist will need to see you again within 30 days to check on your progress and to ensure your prescribed medications are working. He or she may adjust the dosage and/or frequency of your medications based on the results of this follow-up exam, so it is very important that you keep all scheduled appointments. You can easily schedule your appointments online or by calling 216-844-2273.

MONITOR YOUR HEALTH AT HOME

Be aware of the signs and symptoms that your GI bleed may be worsening and know when to seek medical help.

GOOD TO GO: Tips to Help You Stay Healthy Between Appointments

Follow these simple steps at home to monitor your health and manage your symptoms.

  1. Follow healthy eating habits and the diet prescribed by your care team.
  2. Use all medications exactly as prescribed. If you are on anticoagulation or antiplatelet therapy, talk to your doctor about how to best continue these medications.
  3. To minimize the risk of bleeding, avoid non-steroidal anti-inflammatory medications (NSAIDS) unless approved by your doctor. NSAIDS include Ibuprofen, Advil, Naproxen and Aleve. Aspirin is also an NSAID to be avoided unless you are on a daily regimen for your heart – in this case, continue taking it as instructed by your doctor. Tylenol is okay to take for minor aches and pains.
  4. Continue to monitor the color and consistency of your stools. Remember, if you are taking iron supplements or Pepto Bismol, dark stools may be normal.
  5. Exercise. Only you can find the right balance between movement and rest. Try to include 30 minutes of exercise most days – walking is always a good choice – but if you feel dizzy or unwell, stop immediately. Always talk to your doctor before beginning any exercise program.
  6. Avoid alcohol and tobacco. If you are a current smoker, resources to help you quit, include:
    • UH pamphlet, “Smoking Cessation: How to Be a Quitter.”
    • Tobacco Intervention & Psychosocial Support (TIPS) for patients with active cancer. Call 216-368-5643.
    • The Ohio Smoking Cessation Hotline. Call 1-800-QUIT-NOW.

    If you have been diagnosed with GERD (Gastroesophageal Reflux Disease):

    • Avoid the following foods to help reduce symptoms:
      • Caffeine (coffee, regular tea, chocolate)
      • Acidic foods (citrus fruits/juices, carbonated beverages, tomato products)
      • Alcohol and tobacco
      • Mints (peppermint and spearmint)
      • Fried, greasy foods
      • Spicy foods, garlic and onions
    • Eat sitting upright (not slouched or lying down)
    • Stay upright for one hour after eating
    • Avoid eating before bedtime – it is best to not eat four hours before going to bed
    • When sleeping, keep the head of the bed raised by 6 – 8 inches. This can be done by using blocks under the bedposts or using a mattress wedge. Extra pillows will not work.

    If you have been diagnosed with hemorrhoids or diverticulosis:

    • Follow a high fiber diet, with a goal of 20 – 35 grams daily. Good food choices include:
      • Whole grains, including barley, quinoa, whole wheat flour, wild and brown rice and oatmeal
      • Fiber-rich fruits and vegetables, including raspberries, pears, apples, bananas, oranges, plums/prunes, cooked artichoke, peas, broccoli, green lettuce and corn
      • It is OKAY to eat nuts, popcorn and seeds (sunflower, pumpkin, caraway, sesame). Recent research suggests that these foods are NOT harmful to people with diverticulosis and are considered healthy and safe to eat.
    • It is important to avoid constipation. Stools should be soft but formed and bowel movements should be regular. If you think you are constipated, talk to your doctor about medications that might help.
    • If you have hemorrhoids, refrain from straining or lingering on the toilet (reading, for example).

CAUTION: When to Call Your Doctor

If you experience any of these symptoms, you should call your doctor’s office immediately. You may need your medications adjusted and/or blood tests. Continue taking your medications as ordered until you see your doctor.

  • Small amount of blood in your stool or on the toilet tissue
  • Nausea or vomiting
  • Changes in appetite or feeling full faster
  • Weight loss
  • Increased tiredness or weakness

STOP: Call 9-1-1

If you experience persistent black, tarry or red-speckled stools, vomiting red or dark blood, new abdominal pain, shortness of breath, racing heart or heart palpitations, dizziness, lightheadedness, passing out or mental confusion, call 9-1-1 immediately.

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