SymptomsComplaints
The symptoms that occur are usually uncharacteristic: There is kicking; especially in the case of stabbing pain in the right upper abdomen or below the costal arches (medically: epigastrium), a perforating injury is a typical cause. Further consequences of gastrointestinal bleeding (gastrointestinal bleeding) are direct consequences of heavy bleeding, and their extent is also determined by the amount of blood loss. It is caused by the lack of volume: In extreme cases, the severe blood loss can even lead to (volume deficiency) shock.
Blood loss is life-threatening from about 20% of normal blood volume. Typical for upper gastrointestinal bleeding is the vomiting of bloody stomach contents, which is called hematemesis (vomiting, Greek häma= blood) and never occurs with lower gastrointestinal bleeding (gastrointestinal bleeding). The color of the vomit gives the physician further clues as to the location of the source of bleeding: If the blood had contact with the hydrochloric acid of the stomach, the vomit takes on a black color, often described as “coffee grounds”, due to the chemical reaction of the blood pigment heme contained in the blood with the hydrochloric acid to form a product called hematin.
If the blood does not come into contact with hydrochloric acid, e.g. when the oesophagus is bleeding, the vomited blood is light red (if it comes from an artery carrying oxygen-rich blood) or dark red (venous blood). By draining the blood from a source of bleeding in the stomach into the intestines, upper gastrointestinal bleeding can also lead to the discharge of bloody stool. Here, too, a distinction is made between black stool caused by hydrochloric acid (medical term: melena) and red blood, also known as hematochezia, which is stored in the stool.
Contrary to what one might initially suspect when blood exits the intestine, both symptoms occur more frequently in the upper than in the lower gastrointestinal bleeding (gastrointestinal bleeding). A striking feature is the penetrating odor of tarry stools and their sticky, shiny appearance, which makes it easier for the physician to distinguish them from other, possibly similar-looking excretion products (black-colored stools do not have to be gastrointestinal bleeding – this also occurs when taking drugs containing coal, bismuth or iron and has even been described after eating blueberries). It should be noted that the removal of tarry stools always indicates a past start of bleeding: The blood must have been in the intestine for at least eight hours.
and black stools
- Nausea
- Feeling of fullness and
- Pain in the upper abdomen.
- To accelerate the heartbeat (tachycardia) and
- Unrest
- To headaches
- Dizziness and
- Cold weld.
In most cases, as described above, gastric bleeding is only noticed when there is vomiting of blood (hematemesis), black colored stools (tarry stools) or even circulatory disorders caused by a lack of blood (volume deficiency shock). Mild and chronic gastric bleeding can even go unnoticed for a long time and is then only detected by chance during routine medical examinations. The connection between the occurrence of pain in the area of the stomach as an alarming sign and the actual existence of a bleeding is not always necessarily given.
The reason for this is that bleeding in itself does not cause pain, so that bleeding should not be assumed to occur only when there are complaints in the left or middle upper abdomen. Rather, inflammation of the mucous membranes of the stomach (gastritis) and stomach ulcers (ulcus ventriculi) are more likely to cause irritation of the nerves with corresponding painful sensations, whereby both diseases can lead to gastric bleeding in the course of the disease and thus precede it. Pain in the stomach area is therefore more likely to be a symptom of underlying stomach diseases with potential bleeding possibility, although the bleeding need not be present at the time of pain.
Gastric mucosa inflammation can become symptomatic not only of left-sided or middle upper abdominal pain but also of nausea, belching and a feeling of fullness. Noticeable stomach ulcers are mainly perceived as dull and piercing pain immediately after eating. These typical symptoms, both for peptic ulcers and for inflammation of the mucous membranes of the stomach, are however only described by about 50% of all patients; in the other half, these diseases also go unnoticed.
It is also important to note that not every pain in the stomach area is a direct sign of stomach disease. Left-sided and middle upper abdominal pain can also be symptoms of a number of other abdominal diseases, such as diseases of the duodenum (e.g. duodenal ulcer), the pancreas (e.g. pancreatitis), the spleen (splenic attack, splenic laceration) or the kidneys or the urinary tract (kidney stone, ureteral stone, inflammation of the renal pelvis).
