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Upper gastrointestinal bleeding (UGIB) is gastrointestinal bleeding in the upper gastrointestinal tract, commonly defined as bleeding arising from the esophagus, stomach, or duodenum. Blood may be observed in vomit or in altered form as black stool. Depending on the amount of the blood loss, symptoms may include shock.
The symptoms vary from the severity of the disorder. The most classic sign of AEN is the dark pigmentation of esophageal mucosa in an upper endoscopy, usually viewed as an ulcer or as an infectious disease. [6] Necrosis can be found mostly between the three distals of the esophagus, but stops abruptly at the gastroesophageal junction. [2]
An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer. [1] The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain, and upper abdominal pain that improves with eating. [1] With a gastric ulcer, the pain may worsen with eating. [7]
Treatment should continue for 14 days after relief of symptoms. Other therapy options include: Nystatin is an effective treatment for mild esophageal candidiasis. [2] It can be used as (swish, do not swallow) treatment for oral candidiasis that occurs with the use of asthma pumps.
Some people also experience a sensation known as globus esophagus, where it feels as if a ball is lodged in the lower part of the esophagus. The following are additional diseases and conditions that affect the esophagus: Achalasia [1] Acute esophageal necrosis; Barrett's esophagus; Boerhaave syndrome; Caustic injury to the esophagus; Chagas disease
When present, symptoms usually relate to painless bleeding, with vomiting blood (hematemesis) and/or black stools . [3] Less often, Dieulafoy's lesions may cause rectal bleeding (hematochezia), or rarely, iron deficiency anemia. Usually, there are no gastrointestinal symptoms that precede the bleeding (abdominal pain, nausea, etc.).
A Cushing ulcer, named after Harvey Cushing, [1] [2] is a gastric ulcer associated with elevated intracranial pressure. It is also called von Rokitansky –Cushing syndrome. [ 2 ] Apart from the stomach , ulcers may also develop in the proximal duodenum and distal esophagus .
Micrograph of an esophageal biopsy showing herpes eosphagitis, with the characteristic nuclear changes (nuclear moulding, chromatin clumping at the nuclear membrane (margination) and multinucleation). H&E stain. Upper Endoscopy often reveals ulcers throughout the esophagus with intervening normal-appearing mucosa.