Causes Of Upper Gastrointestinal Bleeding

Upper gastrointestinal bleeding refers to bleeding that occurs in the upper part of the digestive tract, specifically above the Treitz ligament. This includes the esophagus, stomach, duodenum, bile ducts, and pancreas. There are several common causes of this condition, which can be categorized into different groups.

Esophageal Conditions

One of the primary causes of upper GI bleeding is related to disorders of the esophagus. These may include esophageal or gastroesophageal mucosal tears, inflammation of the esophagus, mechanical injury to the mucosal blood vessels, or damage caused by exposure to chemical substances. In rare cases, a ruptured aortic aneurysm can also lead to bleeding into the esophagus.

Stomach And Duodenal Disorders

Conditions affecting the stomach and duodenum are another major cause of upper gastrointestinal bleeding. This category includes peptic ulcers, gastritis, duodenitis, benign or malignant tumors, polyps, and congenital vascular malformations. These conditions can damage the mucosal lining and lead to internal bleeding.

Biliary And Pancreatic Diseases

Bleeding can also be associated with diseases of the bile ducts and pancreas. For example, biliary tract disorders such as gallstones, tumors, or parasitic infections like biliary ascariasis can cause bleeding. Similarly, pancreatic tumors or severe cases of pancreatitis may lead to hemorrhage in the upper gastrointestinal tract.

Systemic Illnesses

Some systemic diseases can also result in upper GI bleeding. These include conditions like Henoch-Schönlein purpura (an allergic vasculitis), leukemia, and disseminated intravascular coagulation (DIC), which affect the body's ability to regulate blood clotting and can lead to spontaneous bleeding.

Cirrhosis And Portal Hypertension

In patients with liver cirrhosis, portal hypertension is a major contributing factor to upper GI bleeding. This can lead to complications such as portal hypertensive gastropathy or esophageal and gastric varices, which are swollen veins that can rupture and cause life-threatening bleeding.