What are the symptoms of gastric bleeding

Gastric bleeding is a very common phenomenon nowadays. Most of the time, gastric bleeding is caused by liver diseases such as cirrhosis. Gastric bleeding is also related to gastric ulcers, gastritis, gastric tumors, and malignant tumors. Patients need surgery to solve the problem. In addition to gastric bleeding, patients will also feel obvious nausea, vomiting, esophageal pain, difficulty swallowing, and indigestion.

Causes of symptoms (I) Portal hypertension leading to vascular rupture and bleeding

It is common in post-hepatitis cirrhosis, schistosomiasis cirrhosis, alcoholic cirrhosis, biliary cirrhosis, etc., which lead to rupture and bleeding of esophageal and gastric varicose veins. In addition, portal hypertension can be caused by portal vein obstruction caused by portal vein inflammation, portal vein thrombosis, compression of the portal vein by adjacent tumors, and hepatic vein obstruction.

2. Inflammation and ulcers

1. Inflammation

Reflux esophagitis and acute erosive hemorrhagic gastritis are often caused by alcoholism or oral administration of indomethacin, prednisone, and salicylic acid drugs, leading to acute gastric mucosal damage. In addition, it can also be seen in chronic gastritis, duodenitis, anastomotic stomatitis and remnant gastritis caused by bile reflux after subtotal gastrectomy.

2. Ulcers

Esophageal peptic ulcer, gastric and duodenal ulcer, ulcers of the anastomosis and residual stomach after subtotal gastrectomy, and gastrinoma.

3. Tumor

1. Malignant tumors

Common malignant tumors include esophageal cancer, cardia cancer, gastric cancer, gastric malignant lymphoma, duodenal cancer, gallbladder cancer, pancreatic cancer, and periampullary cancer.

2. Benign tumors

Gastric polyps, gastric hemangiomas, gastric leiomyomas, neurofibromas.

4. Physical or chemical damage

1. Physical damage

Tearing of the esophageal and cardiac mucosa caused by severe vomiting, injury from instrument examination or foreign bodies, and radiation damage caused by deep X-ray irradiation of esophageal cancer.

2. Chemical damage

Acute upper gastrointestinal tract injury caused by strong acids, strong alkalis and other chemical agents.

5. Systemic diseases

1. Blood diseases

Acute and chronic leukemia, hemophilia, thrombocytopenic purpura, disseminated intravascular coagulation, etc.

2. Vascular diseases

Henoch-Schonlein purpura, hereditary hemorrhagic telangiectasia.

3. Stress ulcer

Stress state caused by severe infection, severe brain trauma, cerebral hemorrhage, severe burns, sepsis, physical weakness, severe heart failure, etc.

4. Others

Uremia, systemic lupus erythematosus, hemorrhagic fever, leptospirosis, etc.

(VI) Others

Aneurysm ruptures into the esophagus, stomach, or duodenum; hepatic or splenic artery aneurysm ruptures into the upper digestive tract; and tuberculosis of the stomach and duodenum.

Common diseases include ruptured and bleeding esophageal and gastric varicose veins, esophageal peptic ulcer, gastric and duodenal ulcer, ulcers of anastomosis and residual stomach after subtotal gastrectomy, gastrinoma, esophageal cancer, cardiac cancer, gastric cancer, gastric malignant lymphoma, duodenal cancer, gallbladder cancer, pancreatic cancer, periampullary cancer, gastric polyps, gastric hemangioma, gastric leiomyoma, neurofibroma, acute and chronic leukemia, hemophilia, thrombocytopenic purpura, disseminated intravascular coagulation, allergic purpura, hereditary hemorrhagic telangiectasia, severe infection, severe brain trauma, cerebral hemorrhage, severe burns, sepsis, physical weakness, severe heart failure, uremia, systemic lupus erythematosus, hemorrhagic fever, leptospirosis, gastric and duodenal tuberculosis, etc.

Diagnosis Detailed medical history

1. Upper abdominal pain

A history of chronic cyclical rhythmic upper abdominal pain suggests that the bleeding is most likely from gastric or duodenal ulcers. Bleeding from ulcer disease mostly occurs during the active phase of the ulcer, which is more common in winter and spring. The upper abdominal pain will be relieved after bleeding. If upper abdominal pain persists, or develops progressively without obvious rhythm, or starts out regular and then disappears, gastric cancer or malignant transformation of ulcer disease should be considered. Patients with a history of chronic liver disease or long-term drinking, a history of schistosomiasis, and massive vomiting of blood and black stools without abdominal pain or discomfort should consider esophageal or gastric varicose bleeding. Severe colic in the right upper abdomen accompanied by hematemesis and black stools are conducive to the diagnosis of biliary bleeding.