What can help differentiate between an upper and a lower source of bleeding

What can help differentiate between an upper and a lower source of bleeding? 

Characteristics of a UGI source include the following:

• History includes prior ulcer, chronic liver disease, or use of aspirin or NSAIDs.

• Symptoms include nausea, vomiting, or hematemesis.

• Nasogastric (NG) aspirate contains blood or “coffee grounds” material (NG aspirate positive for bile but negative for blood does NOT rule out a UGI source).

• Serum blood urea nitrogen/creatinine ratio greater than 33 is highly suggestive.

• Melena indicates a UGI source (can also be seen in LGIB, specifically with colon cancer).

Characteristics of an LGI source include the following:

• Absence of UGI symptoms or risk factors indicates an LGI source (not always the case; one recent randomized controlled trial showed that the 15% of UGIB presenting as LGIB did not have UGI symptoms).

• Bright red or maroon blood per rectum indicates an LGI source (although can be seen in brisk UGIB).

15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856
Scroll to Top