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 GI Bleeds.

If you want to follow along with written notes on this topic,

you can follow along at zero definals.com slash upper GI bleed

or in the gastroenterology section of the zero definals medicine book.

Let's get straight into it.

Bleeding from the upper GI tract is a medical emergency that you're going to see a lot when you become a junior doctor.

It involves some form of bleeding from the esophagus, the stomach or the duodenum.

The most common causes are esophageal varices,

which particularly occur in patients with chronic liver disease. Malory vice tears, which is a tear of the esophageal mucus membranes, usually from persistent vomiting. Ulcers of the stomach or the geodenum, and then cancers, again, of the

stomach or duodenum. These patients present with vomiting of blood, which we call hematemesis.

If there's been bleeding into the stomach and that blood has been allowed to digest slightly,

you get something called coffee ground vomit,

which looks a lot like coffee grounds that you'd find at the bottom of a cafeteria.

Molina is a tar-like, black, greasy and offensive-smelling stool that's caused by digestive blood

that's passed through the GI tract.

And then in patients who have large amounts of

blood loss, they can develop hemodynamic instability, which causes a low blood pressure,

tachycardia, and other signs of shock. But you have to bear in mind that young, fit and healthy

patients will compensate really well until they've lost a lot of blood, so this can be a very

worrying sign. The patient might also have signs and symptoms of underlying pathology, so they

might have epigastric pain or dyspepsia if they've got an underlying peptic ulcer,

...