What causes upper gastrointestinal bleeding?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 16, 2024
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The most common causes of upper gastrointestinal bleeding. The first is hemorrhage due to peptic ulcers. The second is bleeding from ruptured esophageal and gastric varices. The third is acute erosive hemorrhagic gastritis. The fourth is bleeding caused by gastric cancer. The fifth is bleeding caused by Mallory-Weiss syndrome. After the occurrence of gastrointestinal bleeding, it is necessary to seek medical attention promptly, undergo treatments like hemostasis and blood transfusion in the hospital, and actively manage the symptoms. If necessary, a gastroscopy can be performed for endoscopic hemostasis. If not treated actively, emaciated individuals' lives may be at risk, so caution is necessary.

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Written by Wu Hai Wu
Gastroenterology
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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 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 Wu Hai Wu
Gastroenterology
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Can you eat egg custard with upper gastrointestinal bleeding?

As for whether one can eat egg custard when experiencing upper gastrointestinal bleeding, it requires specific analysis of the situation. If it is during the acute phase of bleeding, such as just after vomiting blood, at that moment, one cannot eat anything and must fast. If the upper gastrointestinal bleeding has been treated and the patient has largely recovered, then they can eat egg custard, as well as other liquid or semi-liquid foods. Therefore, whether a patient with upper gastrointestinal bleeding can eat egg custard depends on the patient's condition. Once a patient experiences upper gastrointestinal bleeding, it is crucial to seek prompt medical attention at a reputable hospital's gastroenterology department to undergo thorough examinations, such as an endoscopy, to confirm the diagnosis.

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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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Written by Wang Li Bing
Intensive Care Medicine Department
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Upper gastrointestinal bleeding clinical manifestations

Upper gastrointestinal bleeding primarily refers to bleeding above the Treitz ligament. The most common causes in clinical practice are peptic ulcers, rupture of esophagogastric varices, acute erosive hemorrhagic gastritis, gastric cancer, etc. The clinical manifestations of upper gastrointestinal bleeding mainly depend on the volume and speed of the bleeding, with the main symptoms being vomiting blood and black stools. After significant blood loss, patients may experience symptoms of peripheral circulatory failure due to reduced circulating blood volume, such as dizziness, palpitations, fatigue, cold limbs, increased heart rate, and low blood pressure. If the patient enters a state of shock, it could even be life-threatening.