What are the primary sources of upper gastrointestinal (GI) bleeding?

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Last updated: February 15, 2025View editorial policy

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From the Guidelines

The primary sources of upper gastrointestinal (GI) bleeding are peptic ulcer disease, Mallory-Weiss tears, esophagitis, and neoplastic lesions.

Causes of Upper GI Bleeding

  • Peptic ulcer disease: caused by Helicobacter pylori infection or nonsteroidal anti-inflammatory drug use, is the most common cause of non-variceal UGIB 1
  • Mallory-Weiss tears: a tear in the mucous membrane or lining of the lower end of the esophagus, where it connects to the stomach 1
  • Esophagitis: inflammation of the esophagus, often caused by acid reflux or infection 1
  • Neoplastic lesions: tumors or cancerous growths in the upper GI tract 1

Other Causes

  • Gastroduodenal erosions: erosions in the stomach or duodenum, often caused by nonsteroidal anti-inflammatory drug use or stress 1
  • Varices: enlarged veins in the esophagus or stomach, often caused by liver disease 1
  • Vascular malformations: abnormal blood vessels in the upper GI tract, which can cause bleeding 1
  • Rare causes: such as hemobilia, hemosuccus pancreaticus, and aortoenteric fistula 1 It's worth noting that the incidence and mortality rates of UGIB have been declining in recent years, but it remains a significant cause of morbidity and mortality, with mortality rates as high as 14% 1.

From the Research

Primary Sources of Upper GI Bleeding

The primary sources of upper gastrointestinal (GI) bleeding are:

  • Gastric ulcer 2, 3
  • Duodenal ulcer 2, 3
  • Esophageal varices 2, 3
  • Mallory-Weiss tear 2
  • Erosive esophagitis 3

Common Causes of Upper GI Bleeding

The most common causes of upper GI bleeding are:

  • Ulcers (peptic ulcers, gastric ulcers, and duodenal ulcers) 2, 3
  • Varices (esophageal varices) 2, 3
  • Other causes such as erosive esophagitis, and Mallory-Weiss tear 2, 3

Clinical Outcomes

Clinical outcomes related to the source of upper GI bleeding include:

  • Rebleeding rate 2, 3
  • Need for surgical therapy 2, 3
  • Mortality rate 2, 3
  • Association of varices with higher mortality rate 3

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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