Dietary Management for Upper Gastrointestinal Bleeding

When a patient experiences gastrointestinal bleeding, it is essential to perform an endoscopy to determine the exact cause. Depending on the underlying condition, dietary care recommendations may vary. Below are specific guidelines tailored to different clinical scenarios associated with upper gastrointestinal bleeding.

1. Gastrointestinal Bleeding Combined with Pyloric Obstruction

Patients with pyloric obstruction should fast completely and undergo gastrointestinal decompression. This helps reduce pressure in the stomach and prevents further complications while medical or surgical intervention is planned.

2. Bleeding Peptic Ulcer with Visible Vessel Remnant

For patients diagnosed with a bleeding ulcer that has a visible blood vessel during endoscopy, endoscopic treatment is required. Following the procedure, patients are generally advised to remain on a nil-by-mouth (NPO) status for 3–5 days to allow proper healing and prevent rebleeding.

3. Simple Peptic Ulcer Bleeding Without High-Risk Features

In cases of uncomplicated peptic ulcer bleeding, patients may begin consuming soft foods such as noodles, bread, and steamed buns. It is important to ensure that the food temperature is below 30°C to avoid irritating the gastrointestinal lining and triggering further bleeding.

4. Presence of Melena or Hematemesis

If a patient presents with black, tarry stools (melena) or vomiting blood (hematemesis), oral intake should be withheld. This precaution allows the gastrointestinal tract to rest and reduces the risk of aggravating the bleeding episode.

5. Patients with Melena but No Hematemesis

For individuals experiencing only melena and no vomiting of blood, a gradual reintroduction of food is recommended starting with clear liquids like rice water or broth. If the patient remains stable with no worsening symptoms, they can progress to a bland, semi-liquid diet including items like porridge, before transitioning to soft foods such as noodles, bread, and steamed buns. Eventually, the patient can return to a normal, balanced diet as tolerated.