Preferred examination method for upper gastrointestinal bleeding

Written by Wang Li Bing

Intensive Care Medicine Department

Updated on January 13, 2025

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Upper gastrointestinal bleeding is very common clinically. If the patient's respiratory and circulatory systems are stable, an esophagogastroduodenoscopy can be performed to further identify the bleeding site. Of course, it is also necessary to dynamically monitor blood tests and coagulation function, and pay attention to the patient's vomiting and rectal bleeding. The clinical treatment of upper gastrointestinal bleeding mainly involves transfusions to replenish blood volume and conservative medical treatment for hemostasis. If conservative medical treatment is not effective, surgical intervention can be considered.

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Written by Zhu Dan Hua

Gastroenterology

1min 20sec

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Upper gastrointestinal bleeding refers to bleeding that occurs in the upper gastrointestinal tract.

Upper gastrointestinal bleeding generally refers to bleeding caused by esophageal, gastric, and duodenal lesions, which clinically manifests most commonly as vomiting blood and blood in stools. Of course, some patients may also experience symptoms such as dizziness, fatigue, and chest tightness. Common causes to be aware of include inflammation, ulcers, tumors, and vascular malformations, especially gastric and duodenal ulcers which are relatively common in clinical settings. The fastest diagnosis mainly relies on gastroscopy, thus it is recommended that patients who suspect upper gastrointestinal bleeding should undergo a gastroscopy as soon as their condition stabilizes to determine the specific cause of the bleeding, such as digestive tract ulcers or even tumors. For treatment, conservative medical management is initially advised, focusing on aggressive fluid replenishment, acid suppression for gastric protection, and blood volume supplementation. Once the gastroscopy provides a clear diagnosis, the treatment plan should be promptly adjusted.

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Written by Zhu Dan Hua

Gastroenterology

1min 15sec

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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 Zhu Dan Hua

Gastroenterology

1min 12sec

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Can upper gastrointestinal bleeding be cured?

Gastrointestinal bleeding, especially lower gastrointestinal bleeding, is a common and urgent condition in gastroenterology. It is relatively common clinically, and generally has good treatment outcomes. However, due to different causes, the treatment efficacy and methods may vary. For upper gastrointestinal bleeding caused by different reasons, the prognosis also varies. For example, upper gastrointestinal bleeding caused by gastric ulcers generally responds well to medical treatment and usually can be cured. However, if considering upper gastrointestinal bleeding caused by gastric tumors, particularly gastric cancer common among the general population, the treatment outcome may not be as favorable. Besides surgery and chemotherapy, the five-year survival rate is relatively higher, but for advanced-stage gastric tumors, the treatment efficacy is generally poorer and the prognosis is relatively worse.

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Written by Wang Li Bing

Intensive Care Medicine Department

49sec

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What are the characteristic manifestations of upper gastrointestinal bleeding?

The clinical manifestations of upper gastrointestinal bleeding mainly depend on the amount and speed of the patient's bleeding. Clinically, vomiting blood and black stool are characteristic manifestations of upper gastrointestinal bleeding. Secondly, if the patient has a large amount of bleeding, it can lead to a rapid decrease in circulating blood volume and subsequent peripheral circulatory failure. Patients may experience dizziness, palpitations, fatigue, and even fainting. At this point, it is crucial to actively replenish blood volume and stop the bleeding, and provide symptomatic treatment. Thirdly, blood tests can reveal signs of hemorrhagic anemia in patients. Fourthly, after gastrointestinal bleeding, patients generally develop a low fever within 24 hours, which must be actively managed.

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Written by Zhu Dan Hua

Gastroenterology

1min 26sec

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Clinical manifestations of upper gastrointestinal bleeding

Patients with upper gastrointestinal bleeding typically present with vomiting blood or bleeding from the stool. Of course, if the bleeding amount is small, there may be no other discomfort. However, if the bleeding is significant, symptoms may include dizziness, fatigue, chest tightness, and palpitations related to low blood volume. Some patients might also experience abdominal discomfort, such as abdominal pain, bloating, or even indigestion. For those suspected of upper gastrointestinal bleeding, it is advisable to further complete blood tests, stool analysis, and electrocardiograms. It is necessary to promptly carry out a gastroscopy when needed to clarify the cause of the bleeding, and consider if it is due to ulcers or vascular malformations. In the early stages of treatment, symptomatic management should be prioritized, and patients are advised to actively rehydrate to improve symptoms of low blood volume and to transfuse red blood cells if necessary to correct anemia. Once the cause is identified, causative treatment should be added, such as the use of acid-suppressing and gastric-protecting drugs for bleeding associated with peptic ulcers. (The use of medications should be under the guidance of a doctor.)