Symptoms of Upper Gastrointestinal Bleeding

Upper gastrointestinal (GI) bleeding can manifest in various ways depending on the underlying cause, location of the bleed, and the volume and speed of blood loss. These symptoms are also influenced by the patient's overall health condition. The most common signs include vomiting blood or passing blood in the stool, with additional specific symptoms depending on the origin of the bleeding. Below are the key symptoms associated with different sources of upper GI bleeding.

Common Symptoms Based on Bleeding Source

1. Acute Bleeding from the Esophagus or Stomach: This typically presents as hematemesis—vomiting blood. When the blood is fresh, it appears bright red. However, if it has been in the stomach for a while, it may resemble coffee grounds due to the effects of gastric acid.

2. Bleeding from the Lower Duodenum or Beyond: This usually results in melena, which refers to black, tarry stools. It indicates bleeding from the upper or upper-middle gastrointestinal tract, including the duodenum.

3. Biliary Tract Bleeding: Bleeding originating from the biliary system is often accompanied by jaundice (yellowing of the skin and eyes) and biliary colic—severe pain in the upper right abdomen, typically due to gallstones or other bile duct issues.

Other Specific Presentations

4. Ruptured Esophageal Varices: This condition is commonly seen in patients with a history of chronic liver disease such as cirrhosis. A major bleed can significantly worsen liver function and may even lead to hepatic encephalopathy—a condition where the brain functions abnormally due to liver failure.

5. Mallory-Weiss Tear: This refers to a tear in the mucous membrane at the junction of the esophagus and stomach. It typically occurs after episodes of severe vomiting or retching, and can result in hematemesis or blood in the stool.