Gastrointestinal Bleeding

Gastrointestinal bleeding is bleeding anywhere from esophagus to rectum (upper: ulcer/varices/Mallory-Weiss/gastritis/tumor; lower: diverticulosis/angiodysplasia/IBD/hemorrhoids/tumor), presenting with hematemesis/melena/hematochezia and possible hypovolemia. Treatment: ABCs/resuscitation (IV fluids/blood); NPO; IV PPI (and octreotide/antibiotics if variceal); urgent upper endoscopy for upper source; colonoscopy (after bowel prep) for lower source; angiography/CTA if localization fails; endoscopic hemostasis (clips/injection/cautery/band ligation); interventional radiology embolization or surgery if refractory; treat cause (H. pylori/NSAID/tumor/IBD/portal HTN); monitor vitals/Hgb; follow-up.

Common Symptoms

Hematemesis; melena; hematochezia; hypovolemia; by upper/lower source

Causes and Pathogenesis

Mucosal/vascular erosion anywhere in GI tract causes bleeding.

Treatment

Resuscitation; PPI/octreotide; endoscopy/colonoscopy/angiography; IR/surgery if refractory

Preventive Measures

Treat H. pylori/portal HTN/IBD; limit NSAIDs; screening colonoscopy.

Department to Visit

It is recommended to visit the Gastroenterology/Emergency/Critical-care department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.