Clinical manifestations of upper gastrointestinal bleeding

Written by Zhu Dan Hua
Gastroenterology
Updated on March 09, 2025
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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.)

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Written by Zhu Dan Hua
Gastroenterology
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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 Wang Li Bing
Intensive Care Medicine Department
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Upper digestive tract bleeding vomit color

The color of vomit in upper gastrointestinal bleeding primarily relates to the amount of bleeding and the speed of bleeding. If the patient has minor bleeding, the gastric acid may process it, resulting in the vomiting of a coffee-ground-like substance, indicating a smaller amount of bleeding. If the patient has substantial bleeding at a rapid pace, surpassing the gastric acid processing, fresh blood may often be vomited, indicating significant bleeding and a poor prognosis. After upper gastrointestinal bleeding occurs, it is crucial to seek medical attention immediately. In clinical settings, patients are usually given proton pump inhibitors and somatostatin analog drugs to stop the bleeding, and it is vital to promptly conduct a thorough gastroscopy to ascertain the causes of gastrointestinal bleeding and so forth.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What medication is used for upper gastrointestinal bleeding?

Upper gastrointestinal massive bleeding is generally a medical emergency with rapid changes that can even be life-threatening. Immediate anti-shock treatment and rapid blood volume replenishment are necessary. When massive gastrointestinal bleeding occurs, the patient should be kept in a recumbent position for rest, ensuring that the airway remains clear to avoid choking during vomiting, and fasting should be maintained during the bleeding period. In clinical practice, medical treatment mainly includes the following points: firstly, actively preparing blood transfusions to replenish blood volume. Secondly, vasopressin can be used for pharmacological hemostasis. Additionally, treatments with somatostatin and octreotide are also options. Hemostasis can also be achieved through endoscopic treatment. If conservative medical treatment is ineffective, surgical treatment may be considered. (Please use medications under the guidance of a doctor.)

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Written by Wang Li Bing
Intensive Care Medicine Department
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Common Causes of Upper Gastrointestinal Bleeding

The common causes of upper gastrointestinal bleeding mainly include the following points: First, esophageal diseases, such as esophagitis, Mallory-Weiss syndrome. Secondly, peptic ulcers, gastric cancer, acute erosive hemorrhagic gastritis, and then esophageal gastric variceal rupture caused by portal hypertension. There are also diseases of neighboring organs or tissues of the upper digestive tract, such as biliary bleeding, pancreatic diseases involving the duodenum, such as pancreatic cancer, acute pancreatitis complicated by abscess rupture and bleeding. Additionally, there are systemic diseases, such as allergic purpura, hemophilia, leukemia, etc.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What to eat when there is upper gastrointestinal bleeding?

Upper gastrointestinal bleeding is relatively common in clinical practice. Its main causes include bleeding from gastroduodenal ulcers, rupture of esophagogastric varices, and bleeding caused by gastric cancer, among others. When upper gastrointestinal bleeding occurs, it is crucial to seek medical attention promptly. After systematic treatment, if the symptoms of bleeding are controlled, the patient can then consume small amounts of clear broth and thin porridge, and gradually transition back to a normal diet. However, the patient should avoid spicy and irritating foods to prevent the recurrence of gastrointestinal bleeding.