From the Guidelines
Upper gastrointestinal (GI) bleeding is most commonly caused by peptic ulcer disease, accounting for approximately 35-50% of cases, followed by other causes such as gastroesophageal varices, Mallory-Weiss tears, and erosive gastritis or duodenitis. The causes of upper GI bleed can be categorized into several key areas, including:
- Peptic ulcer disease (gastric and duodenal ulcers), often resulting from Helicobacter pylori infection or NSAID use, as reported in 1
- Gastroesophageal varices, typically due to portal hypertension from liver cirrhosis, representing 10-20% of cases
- Mallory-Weiss tears, which are mucosal lacerations at the gastroesophageal junction caused by forceful vomiting or retching, accounting for 5-15% of cases
- Erosive gastritis or duodenitis, often related to alcohol, NSAIDs, or stress, causing about 10% of upper GI bleeds Less common causes include esophagitis, arteriovenous malformations, Dieulafoy's lesions (abnormal submucosal arteries), gastric antral vascular ectasia (GAVE or watermelon stomach), and malignancies of the esophagus, stomach, or duodenum, as noted in 1. Upper GI bleeding typically presents with hematemesis (vomiting blood), melena (black, tarry stools), or hematochezia (bright red blood per rectum) in severe cases, often accompanied by signs of hemodynamic instability in significant bleeds, as described in 1. Prompt evaluation with endoscopy is essential for diagnosis and potential therapeutic intervention, as recommended in 1.
From the Research
Causes of Upper GI Bleed
- Peptic ulcer bleeding 2, 3, 4, 5, 6
- Gastritis 2, 3
- Esophagitis 2, 3
- Variceal bleeding 2, 3, 5
- Mallory-Weiss syndrome 2, 3
- Cancer 2
- Gastroduodenal erosions 3
- Arterio-venous malformations 3
- Dieulafoy's lesion 3
- Upper GI tract tumours and malignancies 3