An upper gastrointestinal (GI) bleed refers to bleeding that occurs in the esophagus, stomach, or the upper part of the small intestine (duodenum). This condition can range from mild to life-threatening and requires prompt medical attention. Understanding its symptoms, causes, and treatment is vital for effective management and prevention.
Symptoms of Upper GI Bleeding
The symptoms of an upper GI bleed can vary based on the severity of the bleeding but commonly include:
- Hematemesis: Vomiting blood, which may appear bright red or resemble coffee grounds.
- Melena: Black, tarry stools indicating digested blood in the gastrointestinal tract.
- Abdominal Pain: Pain or discomfort in the upper abdomen.
- Fatigue: Weakness or dizziness caused by blood loss.
- Pale Skin: A sign of anaemia due to significant blood loss.
- Shock Symptoms (Severe Cases): Rapid heartbeat, low blood pressure, and confusion may occur.
Causes of Upper GI Bleeding
Upper GI bleeding can result from several conditions, including:
- Peptic Ulcers: The most common cause, often due to H. pylori infection or prolonged NSAID use.
- Esophageal Varices: Enlarged veins in the oesophagus, often related to liver disease.
- Gastritis: Inflammation of the stomach lining caused by alcohol, medications, or infections.
- Mallory-Weiss Tears: Tears in the oesophagus due to severe vomiting or coughing.
- Cancer: Tumors in the stomach or oesophagus may lead to bleeding.
- Angiodysplasia: Abnormal blood vessels in the gastrointestinal tract.
Diagnosis of Upper GI Bleeding
Diagnosis involves a combination of medical history, physical examination, and diagnostic tests:
- Endoscopy: A primary tool for identifying the source of bleeding and determining the cause.
- Blood Tests: Evaluate haemoglobin levels, clotting factors, and overall blood loss.
- Imaging Studies: CT angiography or MRI may be used to locate active bleeding.
- Nasogastric Tube Aspiration: Helps determine if blood is present in the stomach.
Prevention of Upper GI Bleeding
Preventive strategies focus on minimizing risk factors:
- Manage NSAID Use: Limit prolonged use of NSAIDs and take them with food or antacids.
- Control H. pylori Infection: Seek treatment for infections to reduce ulcer risk.
- Avoid Excess Alcohol: Alcohol irritates the stomach lining and increases bleeding risk.
- Monitor Liver Health: Manage conditions like cirrhosis to prevent oesophagal varices.
- Healthy Diet: A diet rich in fibre and low in irritants can reduce gastrointestinal inflammation.
Treatment for Upper GI Bleeding
Treatment depends on the cause and severity of the bleed:
1. Endoscopic Intervention:
- Clipping or Banding: Stops bleeding by sealing the source.
- Injection Therapy: Injects medication to constrict blood vessels.
2. Medications:
- Proton Pump Inhibitors (PPIs): Reduce stomach acid and promote healing.
- Antibiotics: Treat H. pylori infections if present.
- Vasoconstrictors: Drugs like octreotide may be used for variceal bleeding.
- Blood Transfusions: To restore lost blood volume in severe cases.
- Surgery: Rarely, surgical intervention may be necessary if endoscopic treatment fails.
- Angiographic Embolization: Blocks blood flow to the bleeding vessel in persistent cases.
Desai Surgical Hospital specializes in managing upper GI bleeding and other complex gastrointestinal conditions. Our advanced diagnostic tools and skilled team of gastroenterologists ensure accurate diagnosis and effective treatment tailored to each patient’s needs. If you experience symptoms of upper GI bleeding, visit us immediately for expert care and support.