Gastric antral vascular ectasia; GAVE
Watermelon stomach is a condition in which the lining of the stomach bleeds, causing it to look like the characteristic stripes of a watermelon when viewed by endoscopy. Although it can develop in men and women of all ages, watermelon stomach is most commonly observed in older women (over age 70 years). Signs and symptoms of watermelon stomach include blood in the stool, hematemesis (vomiting blood) and anemia. The exact cause of watermelon stomach is unknown; however, it is often diagnosed in people with other chronic (long-term) conditions such as cirrhosis (scarring of the liver and poor liver function), autoimmune disease, systemic sclerosis, and CREST syndrome. Treatment consists of surgery and/or medications to stop or control the bleeding.
Watermelon stomach is characterized primarily by gastrointestinal bleeding, which may result in the following signs and symptoms:
- Hematemesis (vomiting blood)
- Blood in the stools
Watermelon stomach has been associated with other conditions, including several autoimmune diseases, atrophic gastritis, cirrhosis, scleroderma, pernicious anemia and CREST syndrome. It can also occur in patients with portal hypertension, vascular disease, diabetes mellitus, metabolic syndrome and chronic renal failure.
The exact cause of watermelon stomach is unknown. However, it is often diagnosed in people with other chronic (long-term) conditions such as cirrhosis (scarring of the liver and poor liver function), autoimmune disease, systemic sclerosis, metabolic syndrome and CREST syndrome.
A diagnosis of watermelon stomach is usually made when rows of flat, reddish stripes on the lining of the stomach (like the stripes of a watermelon) are seen on endoscopy. Other tests, such as a biopsy of the stomach lining, an endoscopic ultrasound (ultrasound probe on the tip of an endoscope), computed tomography (CT scan) and/or a tagged red blood cell scan, may be used to confirm the diagnosis.
Watermelon stomach is usually treated with endoscopic laser surgery or argon plasma coagulation. Both of these procedures are performed by endoscopy. Endoscopic laser surgery uses a laser light to treat bleeding blood vessels, while argon plasma coagulation uses argon gas and electrical current to seal irregular or bleeding tissue.
In some cases, people may be treated with certain medications that help stop or control the gastrointestinal bleeding. Corticosteriods, tranexamic acid, and hormone therapy (with estrogen and progesterone) have been used to treat watermelon stomach with some success.
Depending on the severity of the bleeding, blood transfusions may also be necessary at the time of diagnosis. Additional transfusions may be recommended if gastrointestinal bleeding can not be stopped or controlled.
The long-term outlook (prognosis) for people with watermelon stomach varies. Some affected people have continued or recurrent (appearing again) gastrointestinal bleeding even with treatment. These cases are often considered "transfusion-dependent" since regular blood transfusions are usually necessary. Other affected people respond well to therapy and have no additional bleeding episodes.
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