Diagnostic methods for upper gastrointestinal bleeding

When diagnosing upper gastrointestinal bleeding, we must pay attention to understanding the common causes. Now, bleeding in the esophagus, stomach, duodenum, pancreas, bile duct and other parts of the body are collectively referred to as gastrointestinal bleeding, so we must pay attention to correct diagnosis and symptomatic treatment.

1. Gastrointestinal bleeding is a common clinical disease. Bleeding in the esophagus, stomach, duodenum, pancreas, bile duct and other parts is usually called upper gastrointestinal bleeding; bleeding in the jejunum, ileum and large intestine is called lower gastrointestinal bleeding. Generally speaking, upper gastrointestinal bleeding will cause black stools, most of which are tarry. When there is heavy bleeding, dark red or even bright red stools may also be discharged. It may also be accompanied by vomiting blood, which is mostly coffee-colored or dark brown. When the amount of bleeding is large, the blood stays in the stomach for a short time and appears as dark red blood clots or fresh blood, such as bleeding from esophageal varicose veins in cirrhosis. Lower gastrointestinal bleeding mainly manifests as blood in the stool. Generally speaking, the lower the location of the lesion, the greater the amount of bleeding, the faster the bleeding rate, and the brighter the red of the blood in the stool; conversely, if the lesion is located high, the amount of bleeding is small, the rate is slow, and it stays in the intestine for a long time, the stool may also be black. In addition, blood in the stool caused by anorectal lesions is usually not mixed with feces, but attached to the surface of the stool, or dripping blood after defecation. If there is blood on the surface of the stool and the shape of the stool becomes thinner, you should be alert to the possibility of rectal cancer.

2. According to the bleeding time and amount, it is generally divided into: chronic occult bleeding with only positive stool occult blood confirmed by laboratory methods but no obvious clinical symptoms, chronic overt bleeding with hematemesis and (or) black stools but no symptoms of circulatory disorders, and acute massive bleeding accompanied by symptoms of circulatory disorders. Patients with chronic hidden bleeding are difficult to identify because they have no obvious vomiting of blood or black stools. Some patients have symptoms such as dizziness, fatigue, palpitations and pale complexion due to chronic hidden blood loss, and have been misdiagnosed as cardiovascular and cerebrovascular diseases or blood system diseases for a long time and received incorrect treatment. Patients with acute massive gastrointestinal bleeding have typical symptoms of hematemesis, melena, or bloody stools, which are generally easy to identify. However, if patients who have not experienced vomiting blood or melena suddenly experience symptoms such as dizziness, weakness, thirst, sweating, palpitations, and nausea, they should be alert to the possibility of acute gastrointestinal bleeding and should go to the hospital immediately to avoid missing the best time for treatment. It should be differentiated from bleeding in other parts of the body.

3. Respiratory bleeding is medically known as hemoptysis. At this time, the blood is bright red, or accompanied by blood in the sputum or bubbles and sputum, which is often alkaline. The patient has a history of respiratory disease and respiratory symptoms. Most vomited blood is brown, mixed with food, and acidic, and the patient has a history of gastrointestinal diseases and symptoms. When bleeding occurs due to nasal or oral diseases, blood may also flow out of the mouth, or black stools may appear after the blood is swallowed, but it can be identified based on the presence or absence of a history of oral and nasopharyngeal diseases. In addition, it should also be differentiated from black stools caused by oral bismuth, bone charcoal, iron preparations, etc. The color of this type of black stool is lighter than that of gastrointestinal bleeding, and the fecal occult blood test is negative.