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Upper gastrointestinal bleeding can be caused by peptic ulcers, gastric erosions, esophageal varices, and rarer causes such as gastric cancer. The initial assessment includes measurement of the blood pressure and heart rate, as well as blood tests to determine the hemoglobin.
Peptic ulcer disease is when the inner part of the stomach's gastric mucosa (lining of the stomach), the first part of the small intestine, or sometimes the lower esophagus, gets damaged. An ulcer in the stomach is called a gastric ulcer , while one in the first part of the intestines is a duodenal ulcer . [ 1 ]
If the disease remains untreated, it can cause scarring and discomfort in the esophagus. If the irritation is not allowed to heal, esophagitis can result in esophageal ulcers. Esophagitis can develop into Barrett's esophagus and can increase the risk of esophageal cancer. [3]
Most esophageal cancers fall into one of two classes: esophageal squamous-cell carcinomas (ESCC), which are similar to head and neck cancer in their appearance and association with tobacco and alcohol consumption—and esophageal adenocarcinomas (EAC), which are often associated with a history of GERD and Barrett's esophagus. A rule of thumb is ...
Causes of gastric outlet obstruction include both benign causes, such as peptic ulcer disease affecting the area around the pylorus, and malignant causes, such as gastric cancer. Causation related to ulcers may involve severe pain which the patient may interpret as a heart condition or attack.
Herpes esophagitis is a viral infection of the esophagus caused by Herpes simplex virus (HSV). While the disease most often occurs in immunocompromised patients, including post- chemotherapy , immunosuppression with organ transplants [ 1 ] and in AIDS , [ 2 ] herpes esophagitis can also occur in immunocompetent individuals.
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]
About half of cases are due to peptic ulcer disease (gastric or duodenal ulcers). [3] Esophageal inflammation and erosive disease are the next most common causes. [3] In those with liver cirrhosis, 50–60% of bleeding is due to esophageal varices. [3] Approximately half of those with peptic ulcers have an H. pylori infection. [3]