Upper Gastrointestinal Bleeding: Evaluation and Diagnosis

Upper gastrointestinal bleeding is a common medical emergency that requires prompt diagnosis and intervention. Patients may be hemodynamically stable or unstable depending on bleeding severity and vital signs. Immediate resuscitation and timely diagnosis are paramount to reducing mortality in this extremely vulnerable patient population. Upper gastrointestinal bleeding can be classified into two categories: variceal bleeding and nonvariceal bleeding, both of which can be life-threatening. This article aids bedside practitioners in understanding the pathogenesis of an upper gastrointestinal bleed to identify potential diagnoses. Furthermore, to ensure the proper diagnostic tests are prescribed, the algorithm provides guidance on collecting a pertinent medical history, discusses common presenting symptoms, and identifies the top risk factors for several disease processes that might present as an upper gastrointestinal bleed. A diagnostic algorithm that includes a myriad of the most common differential diagnoses of an upper gastrointestinal bleed is presented as a tool for bedside clinicians to utilize when encountering this serious gastrointestinal phenomenon.