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Upper Gastrointestinal Bleeding

Bleeding originating proximal to the ligament of Treitz, requiring urgent intervention.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Upper Gastrointestinal Bleeding?

Upper gastrointestinal (GI) bleeding includes bleedings originating from the esophagus, stomach, and the first part of the duodenum (proximal to the ligament of Treitz). It manifests with hematemesis (vomiting blood), melena (black stools), and sometimes hematochezia.

The most common causes are peptic ulcer disease, esophageal and gastric varices, Mallory-Weiss tears, erosive gastritis, and malignancies. Helicobacter pylori and NSAID use are responsible for the majority of nonvariceal bleeding.

Glasgow-Blatchford and Rockall scores are used for risk assessment. Hemodynamic stabilization, endoscopic diagnosis, and treatment are life-saving.

Symptoms

Hematemesis (vomiting bright red or 'coffee grounds' appearance blood)
Melena (tarry, foul-smelling stool)
Hematochezia in large-volume bleeding
Dizziness and syncope
Tachycardia and hypotension
Pallor and cold sweating
Fatigue and shortness of breath (anemia)

Risk Factors

History of peptic ulcer
NSAID or aspirin use
Helicobacter pylori infection
Cirrhosis and portal hypertension
Anticoagulant use
Heavy alcohol consumption
Advanced age and comorbidities

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Hematemesis or melena requires emergency department visit
  • If accompanied by dizziness and syncope
  • If bleeding develops while on anticoagulants
  • Bleeding signs in cirrhotic patient
  • If hemodynamic disturbance (hypotension, tachycardia) is present

Treatment Methods

01
Rapid IV fluid resuscitation and blood transfusion if needed
02
IV proton pump inhibitor (pantoprazole) infusion
03
Terlipressin and antibiotic prophylaxis in variceal bleeding
04
Emergency upper GI endoscopy (within 24 hours)
05
Endoscopic hemostasis (sclerotherapy, band ligation, clip, thermal)
06
Angiographic embolization or surgery in failed cases

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dahiliye (İç Hastalıkları) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.