Upper gastrointestinal bleeding includes which areas?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on March 30, 2025
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In clinical practice, bleeding in the digestive system above the ligament of Treitz is referred to as upper gastrointestinal bleeding. It primarily includes the following areas: The first major category is esophageal diseases, such as esophagitis, esophageal trauma, and other causes of bleeding. The second category is duodenal diseases, such as peptic ulcers, acute erosive hemorrhagic gastritis, stomach cancer, etc. Another cause is liver cirrhosis leading to portal hypertension, which can cause rupture and bleeding in esophageal and gastric varices. The fourth category includes biliary system and pancreatic diseases involving the duodenum, such as pancreatic cancer, which can also lead to bleeding.

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Upper gastrointestinal hemorrhage rescue process

First, it is important to address the most life-threatening situations by promptly clearing the airway to prevent blood clots from gastrointestinal bleeding from blocking the bronchi, which can cause choking or asphyxiation. Additionally, it is crucial to timely replenish blood volume, as significant blood loss can directly lead to shock. While combating shock, actively identify the cause of the bleeding. Use a gastroscope for examination, and blood can be stopped under gastroscopy. If it cannot be stopped under gastroscopy, an emergency laparotomy should be performed to carry out a major gastrectomy. Postoperatively, intensive care should be strengthened, actively identifying the cause of gastric bleeding, providing symptomatic treatment, and maintaining regular dietary habits, with meals being on schedule and in fixed amounts.

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Written by Wu Hai Wu
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The cause of vomiting coffee-colored substances due to upper gastrointestinal bleeding.

Upper gastrointestinal bleeding results in the vomiting of coffee-colored blood because the combination of fresh blood with stomach acid forms a coffee-colored liquid. If the bleeding volume exceeds 200mL in a short period, coffee-colored vomit may occur. It is necessary to seek prompt medical attention at a regular hospital’s gastroenterology or emergency department. Adequate diagnosis with an electronic gastroscopy is essential to identify the source and location of the bleeding, and active endoscopic treatment should be undertaken. Additionally, it is crucial to actively replenish fluids, correct the loss of body water, and restore blood volume. Treatment should also include the use of proton pump inhibitors and gastric mucosal protectants.

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Written by Wang Chun Mei
Pulmonology
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Why does pulmonary heart disease cause upper gastrointestinal bleeding?

Cor pulmonale is a very common type of heart disease in the clinic, mainly caused by various etiologies leading to pulmonary arterial hypertension, which results in right ventricular hypertrophy. Typically, patients with this disease have underlying pulmonary and cardiac lesions, and it mainly causes symptoms of varying degrees, such as fever, cough, expectoration, shortness of breath, chest tightness, and even difficulty breathing. Cor pulmonale is a complex disease, and if not managed properly in clinical practice, it can lead to many complications, especially respiratory failure and heart failure. This can lead to insufficient blood and oxygen supply, causing various degrees of increased pressure in the gastric vessels or vascular spasms due to hypoxia, all of which can cause patients to experience upper gastrointestinal bleeding during severe coughing, or when consuming certain foods.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Is upper gastrointestinal bleeding dangerous?

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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Mild upper gastrointestinal bleeding symptoms

Symptoms of mild upper gastrointestinal bleeding mainly include dizziness, fatigue, poor appetite, etc., and there may also be cases of passing black stools. Once a patient experiences black stools accompanied by symptoms such as dizziness and fatigue, upper gastrointestinal bleeding should be considered. It is advisable to visit the gastroenterology department of a reputable hospital as soon as possible to undergo a gastroscopy to promptly determine the cause of the condition. Depending on the different causes, appropriate and active treatment measures should be taken. Additionally, endoscopic hemostasis treatment can also be considered. Patients with mild upper gastrointestinal bleeding should also be extra cautious, as delayed treatment may lead to the possibility of severe upper gastrointestinal bleeding.