Is upper gastrointestinal bleeding dangerous?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 10, 2024
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Upper gastrointestinal bleeding is life-threatening if the amount and speed of bleeding are substantial. Therefore, proactive and effective measures should be taken to rescue the patient. Generally, after anti-shock treatment and rapid blood volume replenishment, the patient's life can be saved. The main clinical treatment measures include the following: First, keep the patient in a recumbent position at rest, ensure that the airway is clear, and prevent blood aspiration due to vomiting. Second, during the bleeding period, it is necessary to enforce fasting, closely monitor the patient's vital signs, such as heartbeat, breathing, blood pressure, consciousness, etc. Third, after hospitalization, it is crucial to actively replenish blood volume, such as transfusing compatible red blood cells, plasma, cryoprecipitate, etc., for fluid expansion. Drugs like proton pump inhibitors and octreotide can be used for hemostasis. If conditions permit, a gastroscopy can be performed to stop the bleeding, and surgical treatment may be considered if necessary.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What kind of stool is there with upper gastrointestinal bleeding?

In clinical terms, the upper gastrointestinal tract refers to the digestive system above the ligament of Treitz, primarily including the duodenum, stomach, and esophagus. If there is a minor amount of bleeding in the upper gastrointestinal tract, the color of the stool may not change significantly. However, if there is substantial bleeding, the blood can react with gastric acid and may form black, tar-like stools. If gastrointestinal bleeding is detected, it is essential to seek medical attention promptly. An endoscopic examination can be performed to establish a clear diagnosis and undertake aggressive treatment, which can potentially save the patient's life.

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Written by Si Li Li
Gastroenterology
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Black stool is bleeding from the upper gastrointestinal tract.

Black stools are generally caused by upper gastrointestinal tract bleeding, which can stem from several reasons: The first one is peptic ulcer, including stomach ulcers and duodenal ulcers; The second is bleeding caused by varices rupturing in the esophagus or stomach due to liver cirrhosis; The third is acute gastric mucosal injury, for example, gastric bleeding caused by orally taken non-steroidal anti-inflammatory drugs; The fourth is gastric hemorrhage caused by gastric cancer. No matter what causes the upper gastrointestinal bleeding, one should promptly visit a hospital, undergo a gastroscopy to determine the cause, and receive timely rescue and treatment. Moreover, during the treatment period, one cannot eat while experiencing gastric bleeding, and must fast until the bleeding stops, after which a liquid diet can be introduced, followed by a transition to a semi-liquid diet.

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Written by Wang Li Bing
Intensive Care Medicine Department
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The most common cause of upper gastrointestinal bleeding

Upper gastrointestinal bleeding is also relatively common clinically. The most common causes mainly include the following points: the first is bleeding from gastric and duodenal ulcers, the second category is esophageal and gastric fundal variceal rupture caused by liver cirrhosis, the third category includes bleeding caused by stress ulcers and acute erosive gastritis, and another category includes bleeding caused by gastric cancer, etc. After upper gastrointestinal bleeding occurs, blood transfusion should be administered to replenish blood volume and stop the bleeding. If conditions allow, a complete gastroscopy should be performed for endoscopic hemostasis. If drug treatment is not effective, surgical treatment may be considered, etc.

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Written by Zhu Dan Hua
Gastroenterology
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Estimating the bleeding amount in upper gastrointestinal bleeding

Upper gastrointestinal bleeding is relatively common in clinical practice, generally manifesting as vomiting blood or defecating blood; typically, the amount of blood vomited is larger while the quantity of blood in stool is less. It can generally be assessed by the following indicators: First, the situation of vomiting blood and blood in stool; second, the change in hemoglobin; third, the change in blood pressure. It is generally believed that if there is a problem with blood pressure, such as low blood pressure, the bleeding is usually significant. Second, by measuring the change in hemoglobin, it is generally considered that a decrease of 10g/L in hemoglobin corresponds to an estimated blood loss of around 400ml; of course, clinically, mild to moderate anemia is especially common. The appearance of vomited blood, generally considered to be more than 250ml, can be accompanied by vomiting and melena, which are commonly seen clinically, whether the bleeding is from the upper or lower gastrointestinal tract.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What are the symptoms of upper gastrointestinal bleeding?

Upper gastrointestinal bleeding is relatively common in clinical practice. Its clinical manifestations mainly relate to the volume and rate of bleeding. Clinically, patients may experience vomiting blood and black stools. If a patient has a large amount of bleeding, they may develop hemorrhagic shock or hemorrhagic anemia, presenting symptoms such as dizziness, palpitations, and weakness. In such cases, patients should seek prompt treatment at a hospital, where they can receive blood transfusions, hemostasis, and volume repletion as active measures. If conditions permit, a gastroscopy can be performed to further clarify the diagnosis.