Acute gastrointestinal hemorrhage

Mar 28, 2023 Source: Cainiu Health

Dr. Zhou Chao

Introduction

Acute gastric bleeding is a common cause of upper gastrointestinal hemorrhage, including hemorrhagic gastritis, gastric ulcer, and duodenal bulb ulcer. It may also be due to serious conditions such as liver cirrhosis or gastric cancer. It is recommended to seek timely medical attention at the gastroenterology department of a hospital. Treatment options include general supportive measures and medication; when necessary, surgical interventions such as variceal decongestion surgery or radical gastrectomy for gastric cancer may be required.

Acute gastric bleeding is a common cause of upper gastrointestinal hemorrhage, including hemorrhagic gastritis, gastric ulcers, and duodenal bulb ulcers. Treatment methods include general management, medication, and surgical intervention. The details are as follows:

1. Hemorrhagic Gastritis

This condition may result from consuming irritating foods or medications, such as excessive alcohol consumption or taking anti-inflammatory drugs. Main symptoms include gastrointestinal bleeding, hematemesis (vomiting blood), and melena (black, tarry stools). It is recommended to rest in bed promptly with the head turned to one side, and to temporarily fast to prevent worsening symptoms. During treatment, the diet should primarily consist of light, liquid, or semi-liquid foods such as milk, millet porridge, and pumpkin porridge, to avoid further irritation to the gastric mucosa.

2. Gastric Ulcer

Increased gastric acid secretion can damage the gastric mucosa or submucosal layers. This area has rich blood supply; during acute episodes of gastric ulcer, local congestion, edema, ulceration, or vessel injury may occur, leading to acute gastric bleeding. If increased gastric acid secretion and mucosal injury are the causes, medications such as omeprazole enteric-coated capsules, pantoprazole enteric-coated tablets, and tranexamic acid tablets may be prescribed under medical supervision to suppress gastric acid secretion, protect the gastric mucosa, and control bleeding.

3. Duodenal Bulb Ulcer

When gastric or duodenal ulcers erode into the stomach or duodenal bulb, they may damage larger blood vessels, causing hematemesis and melena. Treatment includes medications such as lansoprazole tablets and tranexamic acid capsules, as directed by a physician.

In addition, acute gastric bleeding may also result from serious conditions such as liver cirrhosis or gastric cancer. It is recommended to seek timely evaluation at the gastroenterology department of a hospital. If necessary, surgical treatments such as devascularization for gastric varices or radical gastrectomy for gastric cancer may be required.

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Is surgery required for acute gastric bleeding?

Whether surgery is required for acute gastric hemorrhage depends on the patient’s specific clinical condition. Acute gastric hemorrhage—such as that caused by stress ulcers—is a complication secondary to severe burns or trauma. In such cases, surgical intervention is generally contraindicated; instead, management should focus on hemostasis, acid suppression, and supportive care. Conversely, if the hemorrhage originates from a gastric ulcer and is massive and refractory to medical control, surgical intervention is indicated.