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

Written by Zhu Dan Hua
Gastroenterology
Updated on February 05, 2025
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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 Wang Li Bing
Intensive Care Medicine Department
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What are the symptoms of upper gastrointestinal bleeding?

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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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 Wang Li Bing
Intensive Care Medicine Department
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Upper gastrointestinal bleeding includes which areas?

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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Written by Zhu Dan Hua
Gastroenterology
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What medicine is used to stop bleeding in the upper gastrointestinal tract?

Pharmacological treatment for upper gastrointestinal bleeding may include aggressive fluid resuscitation to improve symptoms of hypovolemia, transfusion of red blood cells when necessary to correct anemia, and the use of acid-suppressive and gastroprotective medications to prevent further bleeding. Common causes of upper gastrointestinal bleeding include gastric ulcers, duodenal ulcers, and even vascular anomalies. Therefore, in the early stages, it is advisable to choose acid-suppressive and gastroprotective medications to treat common causes such as gastric ulcers and gastritis, which lead to bleeding. The main symptoms of upper gastrointestinal bleeding are vomiting blood or bleeding from the bowels. In severe cases, the patient may also experience dizziness and fatigue due to low blood volume. For such patients, once the condition stabilizes, it is important to conduct routine blood tests, electrocardiography, and gastroscopy to identify the specific cause of the bleeding. Different causes require different treatment approaches. If the bleeding is suspected to be caused by a tumor, pharmacological treatment may not be very effective, and surgical intervention might be more appropriate. (The use of medications should be under the guidance of a doctor.)

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Written by Wang Li Bing
Intensive Care Medicine Department
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Preferred examination method for upper gastrointestinal bleeding

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.