Upper Gastrointestinal Bleeding
Bleeding from upper digestive tract may be seen either in vomiting or in stool. It is very important to investigate properly the cause of bleeding as hemorrhage may be more than the visible blood loss. In most cases the type of bleeding points to the cause of bleeding.
Some common cause of Upper gastrointestinal bleeding are:
Varices of Esophagus:
Esophageal varices are a complication of long standing liver disease and can bleed anytime (sometime without associated with any significant inciting episode). Normally patients have frequent bouts of blood in vomitus and amount of blood is mostly little in majority of cases.
There are conditions in which explosive vomiting may lead to rupture or bursting of esophagus or a major blood vessel and may lead to bleeding. Rupture of esophagus is mostly associated with alcohol intoxication leading to severe vomiting and if rupture occurs, hemorrhage may be severe and unstoppable by ordinary methods.
Cancer of Esophagus or stomach:
Cancers of esophagus or stomach mostly presents with anemia, bleeding and weight loss. Bleeding from stomach or esophageal cancer is mild mostly unless the tumor is large enough (which is pretty rare due to noticeable symptoms in the early stages of cancer).
Gastric ulcer/ esophageal ulcer:
Gastric ulcer is also an important and fairly common cause of upper gastrointestinal bleeding. Bleeding from ulcer is mostly mild to moderate and associated with a burning chest pain that may mimic a heart attack. Most of the time, bleeding is not fresh (bleeding from ulcer is mostly coffee colored due to partial digestion by stomach acid).
Trauma or injury of upper gastrointestinal tract:
In case of no systemic abnormality, the bleeding may be because of trauma or injury to any part of digestive tract (by aspiration or ingestion of coin or any other sharp or blunt object by accident, seen mostly in children) or mouth (bleeding may be from teeth, gums, throat)
What to do in case of severe bleeding from Upper GI tract?
If you or anyone around you develops sudden explosive vomiting from upper gastrointestinal tract (blood visible through mouth is mostly from upper parts of digestive system), following tips may be life saving:
Ask the person to relax and do not panic. Immediately call for ambulance and before ambulance arrive:
- Make the person comfortably lie on his left side (ideal position to avoid choking of blood into respiratory tubes.
- Counsel the person that he will be fine so that his condition may not deteriorated by anxiety related mistakes.
Try to assess the bleeding source (if it is mouth or blood is coming from deep in) and inquire about the events that led to bleeding (this helps in giving relevant and quick history to emergency medical staff to initiate therapy as soon as possible).
- If the source or site of bleeding is nose, it becomes especially critical to stop bleeding due to risk of choking or entry of blood in wind-pipe (trachea) that may lead to death. If you are certain that the source of bleeding is nose, applying pressure may stop or limit the bleeding.
- For long term management (in case you have frequent bleeding episodes) it is best to see a gastroenterologist to assess your health issues fully.