The gold standard for diagnosing upper gastrointestinal bleeding is gastroscopy, which allows direct visualization of the bleeding site and facilitates appropriate treatment. For patients suspected of having upper gastrointestinal bleeding, gastroscopy is the fastest and most accurate method, and hemostasis can be performed during the procedure. Causes of upper gastrointestinal bleeding include peptic ulcers, esophageal varices, and gastric mucosal lesions; gastroscopy can clarify the cause and guide subsequent treatment.
1. Gastroscopy is the preferred diagnostic method for upper gastrointestinal bleeding. Gastroscopy allows direct observation of the mucosa of the esophagus, stomach, and duodenum, accurately locating the bleeding point. Simultaneously, it enables therapeutic procedures such as biopsy, hemostatic clipping, and sclerotherapy. For patients with acute bleeding, early gastroscopy within 24 hours can significantly improve the diagnostic rate and reduce the risk of rebleeding.
2. Common causes of upper gastrointestinal bleeding include peptic ulcers, esophageal varices, and gastric mucosal lesions. Peptic ulcers are often associated with Helicobacter pylori infection and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs); esophageal varices are common in patients with cirrhosis; and gastric mucosal lesions may be related to stress, medications, or tumors. Gastroscopy can identify the cause and guide targeted treatment.
3. Before gastroscopy, patients need to fast for 6-8 hours to ensure a clear field of vision. For patients with hemodynamic instability, fluid resuscitation and blood transfusion are necessary to stabilize their condition. Sedatives can be used during the examination to reduce discomfort. After the examination, vital signs should be closely monitored for complications such as perforation or aspiration pneumonia.
4. Contraindications for gastroscopy include severe cardiopulmonary insufficiency, patients unable to cooperate, and suspected gastrointestinal perforation. For these patients, other examination methods such as CT angiography or radionuclide scanning may be considered, but these methods are not as accurate or timely as gastroscopy.
5. Treatment for upper gastrointestinal bleeding should be based on the underlying cause. Patients with peptic ulcers may receive proton pump inhibitors and anti-Helicobacter pylori treatment; patients with esophageal varices may undergo endoscopic ligation or sclerotherapy; for patients with severe bleeding or those unresponsive to endoscopic treatment, interventional embolization or surgery may be necessary.
Gastroscopy is the gold standard for diagnosing upper gastrointestinal bleeding. It not only clarifies the cause but also allows for hemostasis during the examination, making it the best option for patients with acute upper gastrointestinal bleeding. For patients suspected of having upper gastrointestinal bleeding, gastroscopy should be performed as early as possible to confirm the diagnosis and initiate targeted treatment. The appropriate endoscopic treatment method should be selected based on the patient's specific condition, and the patient's condition should be closely monitored. If necessary, combined drug therapy or surgical intervention can be used to improve treatment outcomes.