Prisoners feigning blood in vomiting- malhotra bleed

Introduction: An upper gastrointestinal bleed (UGIB) in a prisoner can occur due to the same causes as in the general population, including peptic ulcers, oesophageal varices, Mallory-Weiss tears, gastritis, or even cancerous growths, but there are certain risk factors in prison like stress, poor diet, limited access to healthcare, and potential misuse of medications, leading to a higher likelihood of developing a bleed; for which prompt and early medical evaluation and treatment are crucial. The upper gastro-intestinal bleed is one of the most common indications for endoscopy. There are various reasons for the same and include gastric or duodenal ulcer, erosive gastritis or duodenitis, esophagitis, Mallory Weiss tear, gastric malignancy etc. Many prisoners feign to be having hematemesis but their history and clinical presentation does not match with it. Aim of Study: To determine the truthfulness of upper Gastrointestinal bleed in Prisoners who were referred from jails with complaint of blood vomiting and came for consultation in outdoor patient (OPD) of Medical Gastroenterology Department. Materials and Methods: It was prospective study done at PGIMS, Rohtak, over a period of almost five and half years from 01.10.2019 to 15.02.2025. In this duration, total seventy- five prisoners were referred from various jails with complaints of blood vomiting. Out of these seventy-five prisoners, five never gave consent for endoscopy and seventy underwent upper gastro-intestinal endoscopy. Result: The upper gastro-intestinal endoscopy in all the seventy prisoners was absolutely normal without any evidence of current bleed or recent bleeding stigmata and this false bleed has been termed as Malhotrableed in Prisoners.