Treatment Summary Form for Upper Gastrointestinal Bleeding Due to Peptic Ulcer Disease

Upper gastrointestinal bleeding (UGIB) due to peptic ulcer disease (PUD) is a common medical and surgical emergency, accounting for approximately 40% of cases of upper gastrointestinal bleeding. Approximately 80% of cases may stop bleeding spontaneously; however, the remaining 20% may experience recurrent bleeding after the initial bleeding has stopped. The mortality rate is approximately 5–10% in severe cases, despite medical treatment combined with optimal hemostatic intervention or surgery.

1. Symptoms of Upper Gastrointestinal Bleeding Due to Peptic Ulcer Disease

• Vomiting fresh blood or, in some cases, dark altered blood.
• Passing black, tarry, foul-smelling stools. Bright red blood may be passed if the bleeding is severe.
• Other symptoms may include epigastric pain, lightheadedness, dizziness, fatigue, and pallor.

2. Diagnostic Tests

• Blood tests: complete blood count, urea, creatinine, coagulation tests (PT, aPTT), and testing for H. pylori antibodies, among others.
• Esophagogastroduodenoscopy (EGD): This should generally be performed within 24 hours after bleeding, following initial stabilization, to confirm the cause and assess the severity of bleeding. Endoscopic hemostatic intervention can also be performed when indicated.
• Contrast-enhanced CT angiography of the abdomen and pelvis: May be considered when the cause or bleeding site cannot be identified or when urgent hemostatic intervention is required.

3. Common Causes of Upper Gastrointestinal Bleeding Due to Peptic Ulcer Disease

• H. pylori infection.
• Use of nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and other medications.
• Stress.
• Other related factors, including smoking, alcohol consumption, and genetic factors.

4. Treatment of Upper Gastrointestinal Bleeding Due to Peptic Ulcer Disease

4.1. Treatment Goals

• Stop the bleeding as quickly as possible.
• Promote ulcer healing and prevent disease-related complications.
• Identify and treat the underlying causes of peptic ulcer disease, including H. pylori infection, use of NSAIDs, stress, and lifestyle factors such as smoking and alcohol consumption.

4.2. Treatment Methods

Medical treatment combined with hemostatic interventions, including endoscopic therapy, endovascular intervention, and surgery.

• Medical treatment: Use of acid-suppressing medications, including proton pump inhibitors (PPIs); gastrointestinal mucosal protective agents; correction of coagulation disorders when present; and blood transfusion in cases of significant blood loss.

The information above is for reference purposes only and is not intended as medical advice. Please contact your doctor for detailed medical consultation.