Why is there black stool with upper gastrointestinal bleeding?

Written by Zhu Dan Hua
Gastroenterology
Updated on January 18, 2025
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Gastrointestinal bleeding refers to the condition where blood cells turn black after being decomposed by intestinal bacteria, thus clinically presenting as black stools. Therefore, with a small amount of upper gastrointestinal bleeding, it may simply present as black stools. Of course, with a larger amount of bleeding, it can manifest as vomiting blood or bloody stools, and severe cases may accompany symptoms of low blood flow, such as dizziness, fatigue, chest tightness, etc. For patients with upper gastrointestinal bleeding, it is recommended that they visit the gastroenterology department of a local hospital to undergo further examinations including complete blood count, stool tests, and gastroscopy. Gastroscopy can help identify the location and nature of the bleeding, whether it might be peptic ulcers or gastrointestinal tumors, etc. For treatment, medications that regulate acid and protect the stomach or those that stop bleeding and replenish fluids can be considered symptomatically. Of course, if the black stools are suspected to be caused by a tumor, surgical intervention is generally required.

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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 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.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Which department should I go to for upper gastrointestinal bleeding?

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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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 gastroscopy time

Upper gastrointestinal bleeding is also relatively common in clinical practice. The most common causes are bleeding from peptic ulcers, rupture of esophageal and gastric varices, bleeding caused by gastric cancer, and various emergency bleedings. Once gastrointestinal bleeding occurs, medical attention should be sought promptly. If the patient experiences hemorrhagic shock or hemorrhagic anemia, it is necessary to provide blood transfusions and hemostasis, and replenish blood volume as active treatments. Additionally, for upper gastrointestinal bleeding, it is generally advisable to complete a gastroscopic examination within 24 to 48 hours, which can help clarify the cause of the patient’s gastrointestinal bleeding.