Upper Gastrointestinal Bleeding Causes and Risk Factors

Upper gastrointestinal (GI) bleeding refers to hemorrhage occurring above the Treitz ligament, which marks the transition between the duodenum and jejunum. This type of bleeding can result from a variety of conditions, some more common than others.

Common Causes of Upper GI Bleeding

Peptic Ulcers

One of the most frequent causes of upper GI bleeding is peptic ulcer disease, which includes both gastric ulcers and duodenal ulcers. These ulcers develop when the protective lining of the stomach or duodenum is compromised, often due to Helicobacter pylori infection or the use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Acute Erosive Hemorrhagic Gastritis

Another prevalent cause is acute erosive hemorrhagic gastritis. This condition involves inflammation and erosion of the stomach lining, often triggered by stress, alcohol consumption, or prolonged use of certain medications.

Less Common but Serious Causes

Esophageal and Gastric Varices

Esophageal and gastric varices are dilated veins in the esophagus or stomach that can rupture and cause severe, life-threatening bleeding. These varices are typically associated with liver cirrhosis and portal hypertension. Due to the high pressure in these veins, bleeding can be rapid and substantial.

Malignant Tumors

Although less common, malignancies of the stomach, esophagus, or duodenum can also lead to significant upper GI bleeding. These tumors may erode blood vessels or ulcerate, resulting in acute or chronic blood loss.

Rare Causes of Upper GI Bleeding

Mallory-Weiss Tears

Mallory-Weiss syndrome involves a tear in the mucous membrane at the junction of the esophagus and stomach, usually caused by severe vomiting or retching. This condition can lead to noticeable bleeding, although it is typically less severe than variceal bleeding.

Other Rare Conditions

In rare cases, upper GI bleeding may stem from other sources such as Dieulafoy's lesion (an aberrant artery in the stomach), duodenal diverticula with associated bleeding, or hemorrhage from the biliary tract. These conditions are often overlooked but require prompt diagnosis and treatment.

Understanding the various causes of upper gastrointestinal bleeding is essential for timely diagnosis and effective management. If you suspect GI bleeding, it is crucial to seek medical attention immediately to prevent complications and ensure proper care.