Upper gastrointestinal bleeding includes which areas?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on March 30, 2025
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In clinical practice, bleeding in the digestive system above the ligament of Treitz is referred to as upper gastrointestinal bleeding. It primarily includes the following areas: The first major category is esophageal diseases, such as esophagitis, esophageal trauma, and other causes of bleeding. The second category is duodenal diseases, such as peptic ulcers, acute erosive hemorrhagic gastritis, stomach cancer, etc. Another cause is liver cirrhosis leading to portal hypertension, which can cause rupture and bleeding in esophageal and gastric varices. The fourth category includes biliary system and pancreatic diseases involving the duodenum, such as pancreatic cancer, which can also lead to bleeding.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What are the characteristic manifestations of upper gastrointestinal bleeding?

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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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.

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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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What is good to eat for upper gastrointestinal bleeding?

In the acute phase of upper gastrointestinal bleeding, it is recommended that the patient does not consume food and the bleeding situation is observed. Once the condition stabilizes, a liquid diet can be initiated, which may include water, soups, and porridge. Common causes of upper gastrointestinal bleeding include gastric ulcers, duodenal ulcers, vascular malformations, inflammation, and more. Treatment varies depending on the cause; for gastric and duodenal ulcers, medication is generally an option. If the bleeding is due to vascular malformations or tumors, endoscopic treatment or surgical intervention may be necessary. Upper gastrointestinal bleeding is relatively common clinically, typically presenting with symptoms of vomiting blood and bloody stools. Significant bleeding can also lead to symptoms such as dizziness, weakness, and chest tightness due to low blood volume. Diagnostic procedures mainly include complete blood count, stool tests, electrocardiograms, and crucially, gastroscopy, which is essential for identifying the specific cause of the bleeding.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Is upper gastrointestinal bleeding dangerous?

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.