Upper gastrointestinal bleeding, vomiting blood suggests how much bleeding?

Written by Wu Hai Wu

Gastroenterology

Updated on March 12, 2025

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Upper gastrointestinal bleeding presenting as hematemesis indicates a bleeding volume of at least 200 mL. If a patient experiences upper gastrointestinal bleeding accompanied by vomiting blood, it suggests a significant amount of bleeding and should be taken very seriously. Patients should seek treatment at a specialized gastrointestinal department of a reputable hospital and have an endoscopic examination as soon as possible to confirm the diagnosis. In addition, endoscopic hemostasis can be performed. After the occurrence of hematemesis due to upper gastrointestinal bleeding, it is recommended to be hospitalized for treatment. Treatment should also include the use of hemostatic drugs, acid-suppressing medications, and drugs that protect the gastric mucosa. Acid suppression medications can include proton pump inhibitors or H2 receptor antagonists, among others.

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Written by Wu Hai Wu

Gastroenterology

50sec

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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 Zhu Dan Hua

Gastroenterology

1min 17sec

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Emergency measures for upper gastrointestinal bleeding

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 Zhu Dan Hua

Gastroenterology

1min 26sec

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Clinical manifestations of upper gastrointestinal bleeding

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 Ren Zheng Xin

Gastroenterology

51sec

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Is an upper gastrointestinal perforation serious?

Upper gastrointestinal perforation is most commonly due to gastric perforation caused by gastric ulcers and is considered an emergency in clinical settings. Following the perforation, the contents of the stomach leak into the abdominal cavity, causing diffuse peritonitis and potentially leading to shock; urgent perforation repair surgery is required. If the perforation is caused by a large ulcer, a major part of the stomach may be removed to prevent recurrence of the ulcer. After surgery, it is important to enhance fluid support. If there is a significant peritonitis, timely use of antibiotics is necessary. Post-surgery, it is crucial to rest, focus on dietary adjustments, eat more vegetables and fruits, and consume fewer spicy and greasy foods. (Medication should be taken under the guidance of a doctor.)

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Written by Wang Li Bing

Intensive Care Medicine Department

49sec

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What are the characteristic manifestations of upper gastrointestinal bleeding?

The clinical manifestations of upper gastrointestinal bleeding mainly depend on the amount and speed of the patient's bleeding. Clinically, vomiting blood and black stool are characteristic manifestations of upper gastrointestinal bleeding. Secondly, if the patient has a large amount of bleeding, it can lead to a rapid decrease in circulating blood volume and subsequent peripheral circulatory failure. Patients may experience dizziness, palpitations, fatigue, and even fainting. At this point, it is crucial to actively replenish blood volume and stop the bleeding, and provide symptomatic treatment. Thirdly, blood tests can reveal signs of hemorrhagic anemia in patients. Fourthly, after gastrointestinal bleeding, patients generally develop a low fever within 24 hours, which must be actively managed.