Emergency measures for upper gastrointestinal bleeding

Written by Zhu Dan Hua
Gastroenterology
Updated on March 02, 2025
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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.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Upper gastrointestinal bleeding examination methods

Upper gastrointestinal bleeding is relatively common in clinical practice. The main diagnostic methods include gastroscopy, barium meal examination of the gastrointestinal tract, and DS imaging of the gastrointestinal tract, among others. If a patient experiences a large amount of bleeding at a rapid pace after upper gastrointestinal bleeding, it can lead to a drop in blood volume and hypovolemic shock, which can be life-threatening. In such cases, it is crucial to seek prompt medical treatment and use hemostatic drugs, and even endoscopic hemostasis or surgical intervention may be necessary to actively save the patient's life.

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Written by Wu Hai Wu
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What is the most urgent measure for shock due to upper gastrointestinal bleeding?

When shock occurs due to upper gastrointestinal bleeding, the most urgent treatment measure is to quickly establish intravenous access and actively and rapidly replenish fluids and blood volume. Consideration can be given to the intravenous drip of balanced solutions, Ringer's solution or 5% glucose saline. Fluid replenishment should follow the principles of starting quickly then slowing, and using crystalloids before colloids. At the same time, after shock correction, it is crucial to perform a thorough gastroscopic examination to identify the cause and location of the bleeding, and to undertake the relevant endoscopic treatments. Additionally, patients with upper gastrointestinal bleeding need comprehensive treatment including suppressing acid secretion and protecting the gastric mucosa.

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Written by Jiang Guo Ming
Gastroenterology
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Is upper gastrointestinal bleeding easy to treat?

I can only say that most upper gastrointestinal bleeding can be treated. Common issues such as gastric and duodenal ulcers, complex ulcers, and bleeding caused by acute gastric mucosal lesions can be managed with intravenous or oral administration of proton pump inhibitors, such as omeprazole, lansoprazole, etc., combined with hemostatic drugs and dietary control, often achieving satisfactory therapeutic effects. Cases like bleeding from esophagogastric varices due to liver cirrhosis may require endoscopic sclerotherapy or banding, and sometimes surgery, but recurrent bleeding can occur. Bleeding caused by gastrointestinal tumors requires treatment of the primary disease and often has a poor prognosis. Additionally, bleeding from the gastroduodenal artery, which is severe and urgent, can be addressed with surgical intervention if treatments like endoscopic electrocoagulation are ineffective.

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Written by Wang Li Bing
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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 Wu Hai Wu
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How to determine if upper gastrointestinal bleeding has led to hemorrhagic shock

Patients with upper gastrointestinal bleeding who experience symptoms such as cold sweats, fainting, reduced urine output, dry mouth, etc., may be experiencing hemorrhagic shock and should promptly visit the gastroenterology department or emergency department of a formal hospital for timely emergency treatment. Measures include establishing an intravenous line and actively rehydrating to replenish lost fluids and blood volume. Additionally, if the patient's condition permits, it is crucial to perform a thorough gastroscopy to ascertain the cause and location of the bleeding. When necessary, endoscopic hemostasis can be carried out. Patients with upper gastrointestinal bleeding also need treatments such as acid suppression and protection of the gastric mucosa.