Upper Gastrointestinal Bleeding: Understanding Causes and Risk Factors

Upper gastrointestinal (GI) bleeding is a serious medical condition that occurs in the upper digestive tract, typically involving the esophagus, stomach, or the first part of the small intestine known as the duodenum. One of the most common causes of acute upper GI bleeding is peptic ulcer disease, which accounts for a significant portion of diagnosed cases.

Common Causes of Upper GI Bleeding

Approximately 80 to 90 percent of upper gastrointestinal bleeding cases are attributed to four primary conditions: peptic ulcers, ruptured esophageal and gastric varices, acute erosive hemorrhagic gastritis, and gastric cancer. Each of these conditions can damage the lining of the digestive tract, leading to potentially life-threatening bleeding.

Peptic Ulcers

Peptic ulcers are sores that develop on the lining of the stomach or the duodenum. They are often caused by infection with Helicobacter pylori (H. pylori) bacteria or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Esophageal and Gastric Varices

This condition involves enlarged veins in the esophagus or stomach, often associated with liver cirrhosis. When these veins rupture, they can cause severe and rapid blood loss.

Acute Erosive Hemorrhagic Gastritis

Characterized by inflammation and erosion of the stomach lining, this condition can be triggered by stress, alcohol abuse, or certain medications, leading to bleeding.

Gastric Cancer

As a malignant growth in the stomach, gastric cancer can erode blood vessels and lead to bleeding into the digestive tract.

Other Less Common Causes

Besides the primary causes, several other conditions can also lead to upper GI bleeding. These include esophagitis, esophageal ulcers, esophageal tumors, Mallory-Weiss syndrome (a tear in the mucous membrane at the junction of the esophagus and stomach), hiatal hernia, gastroenteritis, lymphoma, gastrointestinal stromal tumors (GIST), polyps, neurofibromas, gastric volvulus, hookworm infection, pancreatic cancer, pancreatic abscess, and mediastinal tumors or abscesses that erode into the esophagus.

Understanding the wide range of potential causes is crucial for timely diagnosis and effective treatment. If you experience symptoms such as black or tarry stools, vomiting blood, or signs of shock, seek immediate medical attention.