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 Ren Zheng Xin
Gastroenterology
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Is an upper gastrointestinal perforation serious?

Upper gastrointestinal perforation is most commonly due to gastric perforation caused by gastric ulcers and is considered an emergency in clinical settings. Following the perforation, the contents of the stomach leak into the abdominal cavity, causing diffuse peritonitis and potentially leading to shock; urgent perforation repair surgery is required. If the perforation is caused by a large ulcer, a major part of the stomach may be removed to prevent recurrence of the ulcer. After surgery, it is important to enhance fluid support. If there is a significant peritonitis, timely use of antibiotics is necessary. Post-surgery, it is crucial to rest, focus on dietary adjustments, eat more vegetables and fruits, and consume fewer spicy and greasy foods. (Medication should be taken 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 (GI) bleeding is very common in clinical settings, and the main causes of upper GI bleeding include the following: First, gastric and duodenal ulcers, esophageal diseases. Second, esophageal and gastric fundal varices rupture caused by portal hypertension. Third, diseases of organs or tissues adjacent to the upper digestive tract, such as biliary bleeding or pancreatic diseases involving the duodenum, such as pancreatic cancer, as well as aortic aneurysms breaking into the esophagus, stomach, or duodenum. Fourth, systemic diseases, such as allergic purpura, hemophilia, etc., can all lead to upper GI bleeding. After such bleeding occurs, it is essential to seek medical attention promptly.

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Written by Wu Hai Wu
Gastroenterology
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How to determine if upper gastrointestinal bleeding has led to hemorrhagic shock

Patients with upper gastrointestinal bleeding who experience symptoms such as cold sweats, fainting, reduced urine output, dry mouth, etc., may be experiencing hemorrhagic shock and should promptly visit the gastroenterology department or emergency department of a formal hospital for timely emergency treatment. Measures include establishing an intravenous line and actively rehydrating to replenish lost fluids and blood volume. Additionally, if the patient's condition permits, it is crucial to perform a thorough gastroscopy to ascertain the cause and location of the bleeding. When necessary, endoscopic hemostasis can be carried out. Patients with upper gastrointestinal bleeding also need treatments such as acid suppression and protection of the gastric mucosa.

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Written by Wu Hai Wu
Gastroenterology
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Does upper gastrointestinal bleeding always result in black stools and vomiting blood?

Upper gastrointestinal bleeding does not necessarily result in black stools or vomiting of blood. If the bleeding is very minor, such as less than 5ml, there will be no black stools or vomiting blood, and the bleeding can only be detected through a fecal occult blood test which shows a positive result. If the bleeding amounts to about 50ml, vomiting blood may not occur, but black stools can be present. If the bleeding reaches about 200ml and occurs rapidly, both vomiting of blood and black stools may occur simultaneously. Upper gastrointestinal bleeding is a common and critical condition in gastroenterology that requires standardized treatment measures. The first step is to conduct a thorough gastroscopic examination, followed by measures to suppress gastric acid production and protect the gastric mucosa.