Clinical manifestations of upper gastrointestinal bleeding

Written by Zhu Dan Hua
Gastroenterology
Updated on March 09, 2025
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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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What kind of stool is there with upper gastrointestinal bleeding?

In clinical terms, the upper gastrointestinal tract refers to the digestive system above the ligament of Treitz, primarily including the duodenum, stomach, and esophagus. If there is a minor amount of bleeding in the upper gastrointestinal tract, the color of the stool may not change significantly. However, if there is substantial bleeding, the blood can react with gastric acid and may form black, tar-like stools. If gastrointestinal bleeding is detected, it is essential to seek medical attention promptly. An endoscopic examination can be performed to establish a clear diagnosis and undertake aggressive treatment, which can potentially save the patient's life.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What to eat when there is upper gastrointestinal bleeding?

Upper gastrointestinal bleeding is relatively common in clinical practice. Its main causes include bleeding from gastroduodenal ulcers, rupture of esophagogastric varices, and bleeding caused by gastric cancer, among others. When upper gastrointestinal bleeding occurs, it is crucial to seek medical attention promptly. After systematic treatment, if the symptoms of bleeding are controlled, the patient can then consume small amounts of clear broth and thin porridge, and gradually transition back to a normal diet. However, the patient should avoid spicy and irritating foods to prevent the recurrence of gastrointestinal bleeding.

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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.

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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 Wu Hai Wu
Gastroenterology
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Can you drink milk if you have upper gastrointestinal bleeding?

Patients with upper gastrointestinal bleeding are advised not to drink milk. Although milk can dilute gastric acid, it can stimulate the secretion of gastric acid, exacerbating symptoms of upper gastrointestinal bleeding. In severe cases, it can lead to a recurrence of upper gastrointestinal bleeding. Therefore, patients with upper gastrointestinal bleeding should avoid drinking milk during the acute phase. After the onset of upper gastrointestinal bleeding, it is recommended to visit the gastroenterology department of a formal hospital as soon as possible, and complete auxiliary examinations such as an electronic gastroscopy to clarify the diagnosis. Additionally, treatment for upper gastrointestinal bleeding can be carried out through relevant endoscopic therapies. Patients with upper gastrointestinal bleeding should consume easily digestible foods in their diet.