Upper Gastrointestinal Bleeding: Causes, Symptoms, and Treatment

Upper gastrointestinal (GI) bleeding refers to bleeding that occurs in the upper part of the digestive tract, including the esophagus, stomach, duodenum, and the upper portion of the jejunum. It is one of the most common medical emergencies encountered in clinical practice. The condition can present with symptoms such as hematemesis (vomiting blood), melena (black, tarry stools), and signs of anemia. Prompt diagnosis and treatment are crucial to prevent complications and improve patient outcomes.

Common Causes of Upper GI Bleeding

Several underlying conditions can lead to upper gastrointestinal bleeding. Among the most frequent causes are peptic ulcers, erosive gastritis, portal hypertension due to liver cirrhosis, ruptured esophageal varices, gastric cancer, and trauma to the liver. Each of these conditions affects the lining of the digestive tract and can result in significant blood loss if not properly managed.

Recognizing the Symptoms

The clinical presentation of upper GI bleeding varies depending on the location, severity, and speed of blood loss. Patients may experience vomiting blood, dark stools, fatigue, dizziness, and shortness of breath—symptoms often linked to anemia. In severe cases, signs of hypovolemic shock such as rapid heart rate, low blood pressure, and reduced urine output may occur. The patient's overall health condition also plays a significant role in how symptoms manifest.

Diagnostic Approaches

Key Diagnostic Tools

Diagnosing upper GI bleeding involves a comprehensive evaluation of the patient's medical history, physical examination, and a series of diagnostic tests. Vital signs such as pulse and blood pressure, along with urine output and bowel sounds, are closely monitored. Laboratory tests, including liver function tests and hemoglobin levels, provide valuable insights. Advanced procedures like fiberoptic endoscopy and selective angiography are often used to locate the source of bleeding and guide treatment decisions.

Emergency Treatment and Management

Upper GI bleeding is considered a life-threatening condition that requires immediate intervention. Initial management focuses on stabilizing the patient, controlling the bleeding, and treating shock if present. Intravenous fluids and blood transfusions may be necessary to restore blood volume. Endoscopic therapy, medication administration, and in some cases, surgical intervention, are employed to stop the bleeding and address the underlying cause. Long-term management involves identifying and treating the root condition to prevent recurrence.