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 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 Zhu Dan Hua
Gastroenterology
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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 Wang Li Bing
Intensive Care Medicine Department
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Upper digestive tract bleeding vomit color

The color of vomit in upper gastrointestinal bleeding primarily relates to the amount of bleeding and the speed of bleeding. If the patient has minor bleeding, the gastric acid may process it, resulting in the vomiting of a coffee-ground-like substance, indicating a smaller amount of bleeding. If the patient has substantial bleeding at a rapid pace, surpassing the gastric acid processing, fresh blood may often be vomited, indicating significant bleeding and a poor prognosis. After upper gastrointestinal bleeding occurs, it is crucial to seek medical attention immediately. In clinical settings, patients are usually given proton pump inhibitors and somatostatin analog drugs to stop the bleeding, and it is vital to promptly conduct a thorough gastroscopy to ascertain the causes of gastrointestinal bleeding and so forth.

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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 Ren Zheng Xin
Gastroenterology
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Upper gastrointestinal hemorrhage rescue process

First, it is important to address the most life-threatening situations by promptly clearing the airway to prevent blood clots from gastrointestinal bleeding from blocking the bronchi, which can cause choking or asphyxiation. Additionally, it is crucial to timely replenish blood volume, as significant blood loss can directly lead to shock. While combating shock, actively identify the cause of the bleeding. Use a gastroscope for examination, and blood can be stopped under gastroscopy. If it cannot be stopped under gastroscopy, an emergency laparotomy should be performed to carry out a major gastrectomy. Postoperatively, intensive care should be strengthened, actively identifying the cause of gastric bleeding, providing symptomatic treatment, and maintaining regular dietary habits, with meals being on schedule and in fixed amounts.