How to check for gastric bleeding

Gastric bleeding can be diagnosed through gastroscopy, blood routine examination, fecal occult blood test, imaging examination, angiography, and other methods. Gastric bleeding may be related to factors such as peptic ulcers, acute gastric mucosal lesions, esophageal and gastric variceal rupture, gastric cancer, drug damage, etc. It usually manifests as symptoms such as vomiting blood, black stool, dizziness, etc.

1. Gastroscopy

Gastroscopy is the preferred method for diagnosing gastric bleeding, which can directly observe the bleeding site and lesion nature of the esophagus, stomach, and duodenum. Fasting for 6-8 hours is required before the examination, and the doctor will perform tissue biopsy through endoscopy to determine the cause. Gastroscopy can detect active bleeding points, and hemostatic treatments such as electrocoagulation or titanium clip clamping can be performed.

2. Blood routine examination

Blood routine can evaluate the degree of blood loss, with a focus on hemoglobin and hematocrit values. Hemoglobin may remain unchanged in the early stages of acute bleeding and requires dynamic monitoring. If the hemoglobin level is below 70g/L, blood transfusion treatment may be required. This examination can also determine whether there are accompanying conditions such as infection or coagulation dysfunction.

3. Fecal occult blood test

Fecal occult blood test can detect trace gastrointestinal bleeding and is suitable for chronic bleeding patients without obvious vomiting blood or black stool. Three days before the examination, animal blood, red meat, and foods rich in vitamin C should be fasted to avoid false positives. Positive results should be combined with other examinations to identify the bleeding site, while negative results cannot completely rule out the possibility of bleeding.

4. Imaging examination

Abdominal CT or enhanced CT can display lesions such as gastric wall thickening, vascular abnormalities, and tumor space occupying lesions, which are suitable for those who cannot tolerate gastroscopy examination. CT angiography can clearly display vascular malformations or arterial rupture bleeding. Before the examination, oral contrast agent should be taken to fill the gastric cavity, and enhanced scanning is prohibited for those who are allergic to iodine contrast agent.

5. Angiography

Selective intra-abdominal arterial angiography is suitable for cases of active massive bleeding where the blood source is not clearly detected by other examinations. The overflow of contrast agent can directly locate the bleeding point and can also be treated with embolization. This examination is an invasive procedure that requires evaluation of renal function and coagulation function. After surgery, the puncture site needs to be compressed and the patient should be bedridden for 24 hours. After being diagnosed with gastric bleeding, one should strictly fast and gradually transition to a liquid diet such as rice soup, lotus root powder, etc., avoiding spicy and hard foods. After the bleeding stops for 2 weeks, you can try low fiber soft foods with small and frequent meals. It is necessary to avoid taking nonsteroidal anti-inflammatory drugs, drinking alcohol, and other behaviors that damage the gastric mucosa in daily life. If combined with Helicobacter pylori infection, standardized radical treatment is required. If there are symptoms of shock such as palpitations and cold sweats, seek medical attention immediately.