Gastrointestinal bleeding can be a very concerning symptom and the causes of the condition can vary widely. The treatment will largely depend on the cause, severity, and source of the bleeding. Given the proper conditions, vitamin K can be very effective at reducing the amount of bleeding within a few days.
Gastro Intestinal Bleeding
Gastrointestinal bleeding is classically defined as either upper or lower bleeding based on the anatomic origin of the bleed. The ligament of Treitz connects the first part of the small intestine to the diaphragm and is the point used to classify an upper versus a lower gastrointestinal bleed. If the damage and bleeding occur prior to the ligament of Treitz, it is termed as an upper bleed and usually has red blood or blood with the consistency of coffee grounds vomited or aspirated by a suction device. The blood is broken down and passes through the digestive tract and can be passed as a dark black stool. Lower gastrointestinal bleeding is found below the ligament of Treitz and can present with stools showing blood in various colors from partial digestion or bright red if the bleed is low enough on the intestinal tract.
Vitamin K Function
The activity of vitamin K is related to its activation of several clotting factors that enable blood cells to attach to each other and any damaged surfaces in the body. The activation properties given to these clotting factors are done by cells in the liver. Vitamin K is found naturally in two forms, K1 also termed phytonadione and K2 are various compounds called menaquinones. K1 is found in plants and is the type used as medicine for the treatment of acute bleeding. K2 is produced by bacteria that are naturally found in the digestive tract. Menadione and related compounds are a synthetic form of vitamin K
Why is Vitamin K Used
Vitamin K is given because of its properties to activate the clotting factors, form clots in areas that are bleeding, and allow healing of the affected area. Vitamin K requires about 12 hours for effects to begin and 24 to 48 hours for complete normalization of the laboratory values. Because of this delayed time for activation, the blood product fresh frozen plasma is given to patients who are actively bleeding or those who require immediate surgery. Toxicity with both natural forms of vitamin K has not been shown at levels up to 500 times the recommended allowance. Menadione can cause anemia and deposition of by products in the brain of infants therefore it is not therapeutically used.
Who can be Treated with Vitamin K
Gastrointestinal bleeding can be a life-threatening condition requiring immediate surgical intervention. Vitamin K stores in the body will last two to three weeks and are depleted by malnutrition because plants are a source. Depletion can also occur because of liver disease as the clotting factors are activated in the liver. Prolonged antibiotic use contributes to to the eradication of bacteria in the intestinal tract that produce vitamin K. Medical therapy with vitamin K is usually given when the source of bleeding has been identified, the patient is stable and there is an identified vitamin K deficiency or liver disease. It may also be used to patients in acute hemorrhage along with a fresh blood transfusion or fresh plasma, which will give the body all components capable of forming clots.
References
- Goodman & Gilman's"The Pharmacological Basis of Therapeutics";Jeffrey Weitz et al.;2010
- "Cochrane Database of Systematic Reviews";Vitamin K for upper gastrointestinal bleeding in patients with liver diseases; AJ Martí-Carvajal;2005
- "The Washington Manual of Medical Therapeudics";Daniel H Cooper et al.;2007
- "Harrison's Principles of Internal Medicine";Jeffrey Weitz et al.;2008
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