Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be talking to you about upper gastrointestinal bleeding.

And you can find written notes on this topic at zero to finals.com slash upper GI bleed

or in the gastroenterology section of the second edition of the zero to finals medicine book.

So let's get straight into it.

Bleeding from the upper gastrointestinal tract is a relatively common medical emergency.

It involves bleeding from the esophagus, stomach or duodenum. Let's start with the causes.

The key sources of bleeding are peptic ulcers, which are the most common cause of upper GI

bleeding, a malory vice tear, which is a tear in the esophageal mucosa, asophageal varices,

which are usually secondary to portal hypertension

in patients with liver cirrhosis,

and stomach cancers.

So let's go through the presentation.

The presenting features of an upper gastrointestinal bleed are hematemesis, which is vomiting up blood,

coffee ground vomiting, which is vomiting coagulated or clotted blood, which has the appearance of coffee grounds,

and Molina, which is tar-like, black, greasy and offensive stools, which is caused by

digested blood. Hemodynamic instability occurs with significant blood loss, causing a low

blood pressure, tachycardia or a fast heart rate, and other signs of shock.

Young and fit patients may compensate well with normal observations until they've lost a lot of blood.

There are certain features which would point you towards the underlying diagnosis

or the source of bleeding.

Peptic ulcers, for example stomach or duodenal ulcers are associated with

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