Estimating the bleeding amount in upper gastrointestinal bleeding

Written by Zhu Dan Hua
Gastroenterology
Updated on January 08, 2025
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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
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What is good to eat for upper gastrointestinal bleeding?

In the acute phase of upper gastrointestinal bleeding, it is recommended that the patient does not consume food and the bleeding situation is observed. Once the condition stabilizes, a liquid diet can be initiated, which may include water, soups, and porridge. Common causes of upper gastrointestinal bleeding include gastric ulcers, duodenal ulcers, vascular malformations, inflammation, and more. Treatment varies depending on the cause; for gastric and duodenal ulcers, medication is generally an option. If the bleeding is due to vascular malformations or tumors, endoscopic treatment or surgical intervention may be necessary. Upper gastrointestinal bleeding is relatively common clinically, typically presenting with symptoms of vomiting blood and bloody stools. Significant bleeding can also lead to symptoms such as dizziness, weakness, and chest tightness due to low blood volume. Diagnostic procedures mainly include complete blood count, stool tests, electrocardiograms, and crucially, gastroscopy, which is essential for identifying the specific cause of the bleeding.

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Written by Wu Hai Wu
Gastroenterology
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Upper gastrointestinal bleeding, vomiting blood suggests how much bleeding?

Upper gastrointestinal bleeding presenting as hematemesis indicates a bleeding volume of at least 200 mL. If a patient experiences upper gastrointestinal bleeding accompanied by vomiting blood, it suggests a significant amount of bleeding and should be taken very seriously. Patients should seek treatment at a specialized gastrointestinal department of a reputable hospital and have an endoscopic examination as soon as possible to confirm the diagnosis. In addition, endoscopic hemostasis can be performed. After the occurrence of hematemesis due to upper gastrointestinal bleeding, it is recommended to be hospitalized for treatment. Treatment should also include the use of hemostatic drugs, acid-suppressing medications, and drugs that protect the gastric mucosa. Acid suppression medications can include proton pump inhibitors or H2 receptor antagonists, among others.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Upper gastrointestinal bleeding gastroscopy time

Upper gastrointestinal bleeding is also relatively common in clinical practice. The most common causes are bleeding from peptic ulcers, rupture of esophageal and gastric varices, bleeding caused by gastric cancer, and various emergency bleedings. Once gastrointestinal bleeding occurs, medical attention should be sought promptly. If the patient experiences hemorrhagic shock or hemorrhagic anemia, it is necessary to provide blood transfusions and hemostasis, and replenish blood volume as active treatments. Additionally, for upper gastrointestinal bleeding, it is generally advisable to complete a gastroscopic examination within 24 to 48 hours, which can help clarify the cause of the patient’s 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 Zhu Dan Hua
Gastroenterology
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Emergency measures for upper gastrointestinal bleeding

The treatment of upper gastrointestinal bleeding temporarily focuses on fasting and symptomatic fluid replacement. If the patient exhibits significant anemia, actively transfusing red blood cells to correct the anemia is advised. It is recommended that the patient rests in bed, with heart monitoring, blood pressure, and pulse being monitored. As for medications, acid-suppressing, stomach-protecting, and hemostatic drugs may initially be chosen for observation. Once the vital signs and condition have stabilized, it is important to promptly complete routine blood tests, electrocardiograms, and gastroscopy. Among these, gastroscopy is the most crucial diagnostic method, as it can clarify the cause and nature of the bleeding, such as gastric ulcer bleeding, gastric cancer bleeding, etc. Treatment plans vary depending on the cause; if the bleeding is suspected to be due to peptic ulcer disease, medication support is generally the first choice. If the bleeding is suspected to be from malignant transformation of gastric cancer, surgical intervention is typically necessary.