Common Causes of Upper Gastrointestinal Bleeding

Upper gastrointestinal bleeding primarily refers to bleeding that occurs in the esophagus, stomach, and duodenum. The main causes are outlined below:

Peptic Ulcers

Peptic ulcers, including gastric and duodenal ulcers, are among the most common causes of upper GI bleeding, especially in younger individuals. Patients often experience pain, such as hunger pains or nighttime discomfort caused by duodenal ulcers, while gastric ulcers may cause pain after eating. These symptoms can often be managed with acid-reducing medications.

Esophageal and Gastric Varices Due to Liver Cirrhosis

Patients with liver cirrhosis may develop esophageal or gastric varices, which are swollen veins in the esophagus or stomach that can rupture and cause significant bleeding. This type of bleeding typically presents as vomiting blood and can be life-threatening if not treated promptly.

Mallory-Weiss Tear

Another common cause is a Mallory-Weiss tear, which occurs due to severe vomiting or retching. This condition is often seen in pregnant women experiencing extreme morning sickness. The tear typically causes bleeding in the lower esophagus or upper stomach, although the volume of blood loss is usually not very large.

Acute Gastric Mucosal Lesions

Stress-Induced Bleeding

Acute gastric mucosal lesions can develop under stressful conditions, such as a sudden heart attack or intense emotional trauma like the death of a loved one. These lesions may lead to gastrointestinal bleeding, often presenting as black, tarry stools (melena) rather than visible blood.

Dieulafoy's Lesion

A less common but notable cause, particularly in younger individuals, is Dieulafoy's lesion, also known as gastric mucosal arterial syndrome. In this condition, a large, abnormal artery in the stomach fails to taper off as it should, leading to erosion and ulceration of the surrounding mucosa. This can result in sudden and severe gastrointestinal bleeding that may require urgent medical intervention.