Gastrointestinal bleeding can be fatal - something which is not known to many alcoholics. This was the conclusion reached by the Leipzig gastroenterologist Niels Teich and his colleagues, on the basis of a survey in the current edition of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2008; 105: 73-7).
More than 400 patients from the major German cities of Leipzig and Munich were included in the study. Average alcohol consumption was 660 g ethanol per week.
The study shows that alcoholics often do not know enough about the possible symptoms of bleeding in the upper gastrointestinal tract. After vomiting blood, 71% of those asked would contact an emergency physician.
The corresponding figure for a "black fluid" is only 51%. Only 32% would call emergency medical aid if they were to pass black stools, and only 25% would seek medical help for all three symptoms. Alcoholics who rarely see a doctor are particularly ignorant about how urgent treatment is. Women and patients who had seen a doctor more than 12 times in the course of the preceding year were best informed.
Further non-significant differences were found in respect of patient age. Younger alcoholics were more likely to call a doctor than older patients. In addition, earlier consultation of an emergency physician was associated with lower alcohol consumption, completed vocational training, and being married. The longer the patient delays till the emergency endoscopy, the worse is the prognosis.