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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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 cause of upper gastrointestinal bleeding

Upper gastrointestinal bleeding is also relatively common clinically. The most common causes mainly include the following points: the first is bleeding from gastric and duodenal ulcers, the second category is esophageal and gastric fundal variceal rupture caused by liver cirrhosis, the third category includes bleeding caused by stress ulcers and acute erosive gastritis, and another category includes bleeding caused by gastric cancer, etc. After upper gastrointestinal bleeding occurs, blood transfusion should be administered to replenish blood volume and stop the bleeding. If conditions allow, a complete gastroscopy should be performed for endoscopic hemostasis. If drug treatment is not effective, surgical treatment may be considered, etc.

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Written by Wu Hai Wu
Gastroenterology
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Color of vomit due to upper gastrointestinal bleeding

The color of vomit from upper gastrointestinal bleeding can be bright red or coffee-colored liquid. Because if the bleeding in the upper gastrointestinal tract exceeds 200ml, it can lead to vomiting blood. At this time, the vomited blood combines with stomach acid, turning into a coffee-colored liquid. If the bleeding is massive and does not have enough time to mix thoroughly with the stomach acid, it might result in the vomiting of bright red blood. Upper gastrointestinal bleeding is an emergency in gastroenterology, and it requires prompt medical treatment. It's also crucial to thoroughly complete an endoscopic examination to make an accurate diagnosis. If necessary, hemostatic treatment can be performed under gastroscopy.

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Written by Wang Chun Mei
Pulmonology
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Why does pulmonary heart disease cause upper gastrointestinal bleeding?

Cor pulmonale is a very common type of heart disease in the clinic, mainly caused by various etiologies leading to pulmonary arterial hypertension, which results in right ventricular hypertrophy. Typically, patients with this disease have underlying pulmonary and cardiac lesions, and it mainly causes symptoms of varying degrees, such as fever, cough, expectoration, shortness of breath, chest tightness, and even difficulty breathing. Cor pulmonale is a complex disease, and if not managed properly in clinical practice, it can lead to many complications, especially respiratory failure and heart failure. This can lead to insufficient blood and oxygen supply, causing various degrees of increased pressure in the gastric vessels or vascular spasms due to hypoxia, all of which can cause patients to experience upper gastrointestinal bleeding during severe coughing, or when consuming certain foods.

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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.