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Upped GI bleeding is from the esophagus, stomach, or the duodenum, the first 6-8 inches of the
small bowel. It presents itself as vomiting bright red blood or coffee grounds as the stomach acid
digests the blood. If the blood passes down the intestine and comes from the anal canal it is like
coal-tar and called melena.
The common causes are ulcers in the upper digestive tract, various vein related bleed in the
setting of cirrhosis or sometimes from a tear from the junction of the esophagus and stomach
called a Mallory-Weiss tear.
Patients need resuscitation with fluids, sometimes blood and an upper GI endoscopy (EGD) to
diagnose and treat the lesion.
The varicose veins need banding and the ulcers are treated with Epinephrine, coagulation and
sometimes an endoclip.
Prognosis is good unless the varicose are the source in someone with advanced liver disease
as the mortality can be high.
