Is upper gastrointestinal bleeding dangerous?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 10, 2024
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Upper gastrointestinal bleeding is life-threatening if the amount and speed of bleeding are substantial. Therefore, proactive and effective measures should be taken to rescue the patient. Generally, after anti-shock treatment and rapid blood volume replenishment, the patient's life can be saved. The main clinical treatment measures include the following: First, keep the patient in a recumbent position at rest, ensure that the airway is clear, and prevent blood aspiration due to vomiting. Second, during the bleeding period, it is necessary to enforce fasting, closely monitor the patient's vital signs, such as heartbeat, breathing, blood pressure, consciousness, etc. Third, after hospitalization, it is crucial to actively replenish blood volume, such as transfusing compatible red blood cells, plasma, cryoprecipitate, etc., for fluid expansion. Drugs like proton pump inhibitors and octreotide can be used for hemostasis. If conditions permit, a gastroscopy can be performed to stop the bleeding, and surgical treatment may be considered if necessary.

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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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Upper gastrointestinal bleeding examination methods

Upper gastrointestinal bleeding is relatively common in clinical practice. The main diagnostic methods include gastroscopy, barium meal examination of the gastrointestinal tract, and DS imaging of the gastrointestinal tract, among others. If a patient experiences a large amount of bleeding at a rapid pace after upper gastrointestinal bleeding, it can lead to a drop in blood volume and hypovolemic shock, which can be life-threatening. In such cases, it is crucial to seek prompt medical treatment and use hemostatic drugs, and even endoscopic hemostasis or surgical intervention may be necessary to actively save the patient's life.

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Written by Zhu Dan Hua
Gastroenterology
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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 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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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.