What are the characteristic manifestations of upper gastrointestinal bleeding?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 23, 2024
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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.

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Written by Wu Hai Wu
Gastroenterology
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Upper gastrointestinal bleeding, vomiting blood, amount of bleeding.

Patients with upper gastrointestinal bleeding may experience vomiting blood once the stomach bleeding reaches more than 200 mL. The occurrence of vomiting blood also indicates a significant amount of bleeding. Therefore, patients who experience vomiting blood need to actively seek medical attention as soon as possible at the gastroenterology department of a reputable hospital. If the condition permits, a thorough examination with an electronic gastroscope should be carried out promptly to determine the cause, location, and amount of the bleeding. Endoscopic hemostasis can also be performed at the same time. If necessary, oral or intravenous medications that suppress gastric acid secretion can be administered, along with other comprehensive treatments.

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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
Intensive Care Medicine Department
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What to eat when there is upper gastrointestinal bleeding?

Upper gastrointestinal bleeding is relatively common in clinical practice. Its main causes include bleeding from gastroduodenal ulcers, rupture of esophagogastric varices, and bleeding caused by gastric cancer, among others. When upper gastrointestinal bleeding occurs, it is crucial to seek medical attention promptly. After systematic treatment, if the symptoms of bleeding are controlled, the patient can then consume small amounts of clear broth and thin porridge, and gradually transition back to a normal diet. However, the patient should avoid spicy and irritating foods to prevent the recurrence of gastrointestinal bleeding.

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Written by Wu Hai Wu
Gastroenterology
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Can you drink milk if you have upper gastrointestinal bleeding?

Patients with upper gastrointestinal bleeding are advised not to drink milk. Although milk can dilute gastric acid, it can stimulate the secretion of gastric acid, exacerbating symptoms of upper gastrointestinal bleeding. In severe cases, it can lead to a recurrence of upper gastrointestinal bleeding. Therefore, patients with upper gastrointestinal bleeding should avoid drinking milk during the acute phase. After the onset of upper gastrointestinal bleeding, it is recommended to visit the gastroenterology department of a formal hospital as soon as possible, and complete auxiliary examinations such as an electronic gastroscopy to clarify the diagnosis. Additionally, treatment for upper gastrointestinal bleeding can be carried out through relevant endoscopic therapies. Patients with upper gastrointestinal bleeding should consume easily digestible foods in their diet.

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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.