This document defines different types of gastrointestinal bleeding and their associated symptoms. Upper GI bleeding originates from the esophagus, stomach or duodenum and can cause haematemesis (vomiting of blood) or coffee ground vomitus. Lower GI bleeding originates from the small bowel or colon and can cause melena (black tarry stools) or hematochezia (fresh blood in stool). The document notes that bright red haematemesis implies active upper GI bleeding, which is a major medical emergency. It also lists causes of upper GI bleeding and references management guidelines, with plans to cover differential diagnosis of GI bleeding in more detail later.

1. Gastrointestinal Bleeding
Clinical Medicine
Prepared: Chy Yong

4. Definitions
 Upper GIB is that originating proximal to the ligament of Treitz; in
practice from the oesophagus, stomach and duodenum.
 Lower GIB is that originating from the small bowel and colon.
 Haematemesis ( and coffee-ground vomitus) is vomiting of blood from
the upper GI tract or occasionally after swallowing blood from a source in
the nasopharynx. Bright red haematemesis usually implies active
haemorrhage from the esophagus, stomach or duodenum. This can lead to
circulatory collapse and constitutes a major medical emergency.
 Coffee-ground vomitus refers to the vomiting of black material which is
assumed to be blood. Its presence implies that bleeding has ceased or has
been relatively modest.
 Menela is the passage of black tarry stools usually due to acute Upper GIB
but occasionally from bleeding within the small bowel or right side of the
colon.
 Hemtaochezia is the passage of fresh or altered blood per rectum usually
due to colonic bleeding. Occasionally profuse upper GI or small bowel
bleeding can be repsponsible

9. Causes of Upper GIB

28. Recommendations

33. Management in
Acute Upper
GIB Guideline

44. It’s not full of GI
bleeding.
Differential diagnosis of
GIB will be prepare the
next.
Thank You