The main symptoms of patients with upper gastrointestinal bleeding are vomiting blood and black stools. Excessive and urgent bleeding may manifest as vomiting blood; If the amount of bleeding is small or slow, the main method is to relieve black stools. Patients who vomit blood will have black stools within a few days after vomiting blood. The color of vomiting blood can manifest as coffee, dark red, or bright red depending on the amount of bleeding, the speed of bleeding, and the duration of stay in the stomach. Before vomiting blood, there is often nausea and discomfort in the upper abdomen (commonly known as the heart pit). Excessive vomiting of blood accompanied by severe shock symptoms, such as dizziness, palpitations, thirst, cold sweating, and fainting, is considered as upper gastrointestinal bleeding, and the condition is more critical. Currently entering winter, people are prone to anxiety, mental tension, and emotional instability, which have a significant impact on the onset of gastric and duodenal ulcers. The following diseases often lead to massive upper gastrointestinal bleeding, and patients should pay attention to prevention.
1. Gastric and duodenal ulcers: account for more than half of upper gastrointestinal bleeding. Three quarters of them are duodenal ulcers. Ulcers with heavy bleeding are mostly chronic ulcers, usually located on the posterior wall of the duodenal bulb or the lesser curvature of the stomach. Due to the erosion and rupture of the artery at the base of the ulcer, the rupture lacks the ability to contract, and bleeding is often difficult to stop on its own.
2. Portal hypertension: accounts for about 25%, mostly caused by liver cirrhosis, accompanied by esophageal and gastric varices. The mucosa of the esophagus and stomach fundus becomes thinner due to varicose veins, which are easily damaged by rough food and corroded by reflux gastric juice. In addition, the increased pressure in the portal vein system leads to the rupture of the varicose veins, resulting in uncontrollable massive bleeding.
3. Hemorrhagic gastritis: also known as erosive gastritis or stress ulcer, accounting for approximately 5%. It is mostly located in the gastric antrum and is related to alcoholism, taking aspirin, prednisone, indomethacin, or adrenal corticosteroids.
4. Biliary tract bleeding: Localized infection within the liver can cause dilation of the intrahepatic bile duct, accompanied by multiple abscesses; The abscess directly ruptures the portal vein or hepatic artery branch, causing a large amount of blood to flow into the bile duct and then into the duodenum. Liver cancer, hepatic hemangioma, and central rupture of liver parenchyma (hematoma) caused by trauma can also lead to massive intrahepatic biliary bleeding.
5. Gastric cancer: Gastric cancer is also a common disease that causes upper gastrointestinal bleeding. Due to ischemic necrosis of cancer tissue, surface erosion or ulceration occurs, eroding blood vessels and causing massive bleeding. In addition, middle-aged and elderly people with upper gastrointestinal bleeding, especially those with chronic anemia, should be alert to the possibility of gastric cancer.
6. Drinking alcohol or medication: Drinking a large amount of alcohol or taking certain medications for a long time, such as steroids (such as prednisone) or antipyretic and analgesic drugs (such as aspirin, indomethacin, Fenbid, etc.), can easily cause erosion of the gastric and duodenal mucosa, induce gastric and duodenal ulcers, and concurrent upper gastrointestinal bleeding.
Therefore, patients with ulcers should pay special attention to the regularity of daily life and diet, moderate work, and mental relaxation when the weather becomes cold. Avoid raw, cold, coarse, hard, and stimulating foods in diet, such as strong liquor, strong tea, strong coffee, ginger, and garlic. Avoid foods that are too sweet, sticky, and difficult to digest, and avoid excessive hunger and fullness. For patients with recurrent gastric and duodenal ulcers or concurrent bleeding, maintenance therapy is an important treatment measure to prevent recurrence, in addition to eradicating Helicobacter pylori in the stomach. In addition, after experiencing upper gastrointestinal bleeding, first do not be nervous and maintain calmness. If it is only black stool, it should be accompanied by family members to the hospital for treatment as soon as possible. If there is vomiting blood, which is fresh or dark red blood, and there is dizziness, palpitations, cold sweats, and weakness throughout the body, one should immediately rest in bed and hold their head and feet high to ensure sufficient blood flows back to the heart and ensure blood supply to the brain. Family members should also tilt the patient’s head to one side to prevent blood from being sucked into the trachea and causing suffocation. At the same time, they should call an ambulance as soon as possible to urgently transport the patient to the hospital, and temporarily fast when vomiting blood.