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 Jiang Guo Ming
Gastroenterology
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Upper gastrointestinal bleeding causes

The most common cause of upper gastrointestinal bleeding is likely peptic ulcers, such as stomach ulcers, duodenal bulb ulcers, and compound ulcers. Other conditions, such as acute gastric mucosal lesions caused by medication, can also lead to gastrointestinal bleeding. Gastrointestinal tumors, such as esophageal cancer, stomach cancer, and duodenal cancer, can also invade blood vessels and cause upper gastrointestinal bleeding. Vascular diseases, such as varicose veins of the esophagus and stomach base caused by liver cirrhosis, can rupture and lead to upper gastrointestinal bleeding. Massive bleeding can also occur due to the rupture of the gastric artery. Other conditions, like systemic diseases and blood disorders, can lead to thrombocytopenia or coagulation dysfunction, which can also result in upper gastrointestinal bleeding.

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

The most common symptoms of upper gastrointestinal bleeding mainly include: vomiting blood, black stools, or symptoms such as dizziness, palpitations, and fatigue, and even hypovolemic shock and hypovolemic anemia, etc. Therefore, when gastrointestinal bleeding occurs, if the patient has a large amount of bleeding and the bleeding is rapid, it is necessary to seek medical attention promptly, to administer fluid replenishment, volume expansion, and blood transfusion to replenish blood volume, along with symptomatic treatment such as medication and endoscopic hemostasis. If conservative treatment is ineffective, surgical treatment may be considered to avoid life-threatening risks.

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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 (GI) bleeding is very common in clinical settings, and the main causes of upper GI bleeding include the following: First, gastric and duodenal ulcers, esophageal diseases. Second, esophageal and gastric fundal varices rupture caused by portal hypertension. Third, diseases of organs or tissues adjacent to the upper digestive tract, such as biliary bleeding or pancreatic diseases involving the duodenum, such as pancreatic cancer, as well as aortic aneurysms breaking into the esophagus, stomach, or duodenum. Fourth, systemic diseases, such as allergic purpura, hemophilia, etc., can all lead to upper GI bleeding. After such bleeding occurs, it is essential to seek medical attention promptly.

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Written by Wang Li Bing
Intensive Care Medicine Department
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How to treat upper gastrointestinal bleeding?

After gastrointestinal bleeding, the patient should be kept in a recumbent position to rest and ensure that the airway is clear to avoid aspiration of blood due to vomiting. Close monitoring of the patient's vital signs, such as heart rate, blood pressure, and breathing, is necessary. It is important to actively replenish blood volume, correct hypovolemic shock, and administer medications for hemostasis. Endoscopic hemostasis with a gastroscope can also be used. If conservative drug treatment is not effective, surgical treatment may be considered. Emergency treatment is essential after gastrointestinal bleeding, as delays can be life-threatening.