![]() Case one was a 37-year old railroad worker from lowland to a construction site at 4505 m. GIB was obviously related to drinking alcohol and use of aspirin and/or dexamethasone in 3 patients. Informed consent was obtained verbally for each subject. The protocol was approved by the Qinghai High Altitude Medical Research Institute Committee on Human Research. Physical examination, routine blood tests, chest roentgenograms, electrocardiograms, etc were performed. The temperature in winter ranged between -27☌ and -36☌, with an annual average temperature of -3☌ to -7☌.Ī questionnaire was delivered to the persons to be investigated, including age, gender, ethnicity, occupation, place of birth, length of time at low altitude, length of time after ascending to high altitude, history of smoking and consumption of alcoholic beverages, current and past medical history, and family history.Īll subjects underwent a careful medical evaluation before and after ascending to high altitude. Workers were not only exposed to a hypoxic environment, but also to severe cold. The weather and climatologic data were provided by the Tanggula Meteorological Observatory Station and the Qinghai Weather Bureau. This paper describes the incidence, clinical features, and risk factors for GIB in the railroad construction workers on Mountain Tanggula. The construction of railroad on Mountain Tanggula offered a unique opportunity for investigation and study of AMS, high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE), as well as high altitude GIB. Furthermore, data on GIB are available from Japanese, Chinese, and Peruvians, but rarely reported in western people.Īltitude problems are of great importance for the railroad construction workers at high altitude. Gastrointestinal symptoms include nausea/vomiting, loss of appetite, stomach/abdominal pain, constipation, however, the GIB is not included in the diagnostic criteria. ![]() There are two diagnostic criteria for acute mountain sickness (AMS), one is the ESQIII and the other is the Lake Louise consensus scoring system. Moreover, epidemiological and clinical studies suggest that gastrointestinal bleeding (GIB) is not uncommon at high altitude, and is often life-threatening. In fact, symptoms of the digestive system such as anorexia, epigastric discomfort, epigastralgia, heart burn, dyspepsia, nausea, vomiting, diarrhea, haematemesis, piles and peptic ulcers are frequently found in mountaineers and altitude sojourners. Death due to altitude GIB can be avoided if early symptoms and signs are recognized.Īlthough cardiac, respiratory and neurological symptoms are more common among mountaineers and persons from lowland going to the high altitude, little work has been done on the effect of hypoxia on digestive system in either patients with altitude illness or in healthy individuals at high altitude. Early diagnosis, treatment and evacuation lead to an early recovery. ![]() Early diagnosis, evacuation, and treatment led to early recovery.ĬONCLUSION: GIB is a potentially life threatening disease, if it is not treated promptly and effectively. ![]() Persons who previously suffered from peptic ulcer or high-altitude polycythemia were also at risk of developing GIB. Those who consumed large amount of alcohol, aspirin or dexamethasone were at a higher risk of developing GIB. Experimental studies suggested that acute gastric mucosal lesion (AGML) could be induced by hypoxic and cold stress, which might be the pathogenesis of altitude GIB. Endoscopic examination showed that the causes of altitude GIB included hemorrhage gastritis, gastric ulcer, duodenal ulcer, and gastric erosion. Bleeding manifested as hematemesis, melaena or hematochezia, and might be occult. The onset of symptoms in most patients was within three weeks after arrival at high altitude. The incidence increased with increasing altitude. RESULTS: The overall incidence of GIB was 0.49% in 13 502 workers. The available data on altitude GIB were analyzed. Endoscopy was performed when the workers evacuated to Golmud (2808 m) and Xining (2261 m). The incidence of GIB in workers at different altitudes was recorded. METHODS: From 2001 to October 2003, we studied GIB in 13 502 workers constructing the railroad on Mountain Tanggula which is 4905 m above the sea level. AIM: To investigate the gastrointestinal bleeding (GIB) in people from lowland to high altitude and in workers on Mountain Tanggula and its causes as well as treatment and prophylaxis.
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