Common causes of upper gastrointestinal bleeding

Written by Zhu Dan Hua
Gastroenterology
Updated on June 13, 2025
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Common causes of upper gastrointestinal bleeding include gastric ulcers, duodenal ulcers, gastrointestinal tumors, and even vascular malformations. Upper gastrointestinal bleeding is a medical emergency in the field of internal medicine and is generally treated in gastroenterology or emergency departments. Most patients present with vomiting blood or having bloody stools. Of course, patients with significant bleeding may experience symptoms of low blood volume such as dizziness, fatigue, chest tightness, and palpitations. Therefore, patients with the aforementioned symptoms are advised to seek timely treatment in the gastroenterology or emergency department. It is recommended to complete routine blood tests, electrocardiograms, and gastroscopic examinations. If necessary, further examinations such as colonoscopy or abdominal CT scans should be done to determine the cause. The treatment is primarily supportive at this stage, including fasting, rest, and monitoring vital signs. For medication, active fluid replenishment and anemia correction to improve low blood volume symptoms are recommended. Different causes require different treatment plans. If an ulcer is suspected, acid-suppressing and stomach-protecting medicines may be added. If tumor bleeding is considered, surgical intervention is generally required.

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Written by Wang Li Bing
Intensive Care Medicine Department
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How to treat upper gastrointestinal bleeding?

After gastrointestinal bleeding, the patient should be kept in a recumbent position to rest and ensure that the airway is clear to avoid aspiration of blood due to vomiting. Close monitoring of the patient's vital signs, such as heart rate, blood pressure, and breathing, is necessary. It is important to actively replenish blood volume, correct hypovolemic shock, and administer medications for hemostasis. Endoscopic hemostasis with a gastroscope can also be used. If conservative drug treatment is not effective, surgical treatment may be considered. Emergency treatment is essential after gastrointestinal bleeding, as delays can be life-threatening.

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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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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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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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Written by Wang Li Bing
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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.