Which department should I go to for upper gastrointestinal bleeding?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 05, 2024
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The upper gastrointestinal system primarily refers to bleeding from the digestive system above the Treitz ligament. Therefore, if there is acute massive bleeding in the digestive tract, patients may present with symptoms such as vomiting blood and black stools. If the bleeding is significant and blood volume rapidly decreases, it can cause acute peripheral circulatory disorders, and may even be life-threatening. The causes of upper gastrointestinal bleeding include long-standing conditions like peptic ulcers, rupture of esophagogastric varices, acute erosive hemorrhagic gastritis, and stomach cancer, among others. If upper gastrointestinal bleeding occurs, patients should actively seek medical attention at major hospitals' gastroenterology departments, undergo relevant examinations, and receive prompt treatment.

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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.

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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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The cause of vomiting coffee-colored substances due to upper gastrointestinal bleeding.

Upper gastrointestinal bleeding results in the vomiting of coffee-colored blood because the combination of fresh blood with stomach acid forms a coffee-colored liquid. If the bleeding volume exceeds 200mL in a short period, coffee-colored vomit may occur. It is necessary to seek prompt medical attention at a regular hospital’s gastroenterology or emergency department. Adequate diagnosis with an electronic gastroscopy is essential to identify the source and location of the bleeding, and active endoscopic treatment should be undertaken. Additionally, it is crucial to actively replenish fluids, correct the loss of body water, and restore blood volume. Treatment should also include the use of proton pump inhibitors and gastric mucosal protectants.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What medication is used for upper gastrointestinal bleeding?

Upper gastrointestinal massive bleeding is generally a medical emergency with rapid changes that can even be life-threatening. Immediate anti-shock treatment and rapid blood volume replenishment are necessary. When massive gastrointestinal bleeding occurs, the patient should be kept in a recumbent position for rest, ensuring that the airway remains clear to avoid choking during vomiting, and fasting should be maintained during the bleeding period. In clinical practice, medical treatment mainly includes the following points: firstly, actively preparing blood transfusions to replenish blood volume. Secondly, vasopressin can be used for pharmacological hemostasis. Additionally, treatments with somatostatin and octreotide are also options. Hemostasis can also be achieved through endoscopic treatment. If conservative medical treatment is ineffective, surgical treatment may be considered. (Please use medications under the guidance of a doctor.)

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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.