What are the symptoms of upper gastrointestinal bleeding?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 03, 2024
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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.

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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 Zhu Dan Hua
Gastroenterology
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Why is there black stool with upper gastrointestinal bleeding?

Gastrointestinal bleeding refers to the condition where blood cells turn black after being decomposed by intestinal bacteria, thus clinically presenting as black stools. Therefore, with a small amount of upper gastrointestinal bleeding, it may simply present as black stools. Of course, with a larger amount of bleeding, it can manifest as vomiting blood or bloody stools, and severe cases may accompany symptoms of low blood flow, such as dizziness, fatigue, chest tightness, etc. For patients with upper gastrointestinal bleeding, it is recommended that they visit the gastroenterology department of a local hospital to undergo further examinations including complete blood count, stool tests, and gastroscopy. Gastroscopy can help identify the location and nature of the bleeding, whether it might be peptic ulcers or gastrointestinal tumors, etc. For treatment, medications that regulate acid and protect the stomach or those that stop bleeding and replenish fluids can be considered symptomatically. Of course, if the black stools are suspected to be caused by a tumor, surgical intervention is generally required.

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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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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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Which department should I go to for upper gastrointestinal bleeding?

The upper gastrointestinal system primarily refers to bleeding from the digestive system above the Treitz ligament. Therefore, if there is acute massive bleeding in the digestive tract, patients may present with symptoms such as vomiting blood and black stools. If the bleeding is significant and blood volume rapidly decreases, it can cause acute peripheral circulatory disorders, and may even be life-threatening. The causes of upper gastrointestinal bleeding include long-standing conditions like peptic ulcers, rupture of esophagogastric varices, acute erosive hemorrhagic gastritis, and stomach cancer, among others. If upper gastrointestinal bleeding occurs, patients should actively seek medical attention at major hospitals' gastroenterology departments, undergo relevant examinations, and receive prompt treatment.