clinical features

Last reviewed 10/2023

Haematemesis and melaena are characteristic of an upper gastrointestinal bleed.

In the history, ask the patient about:

  • dyspepsia
  • alcohol abuse
  • ingestion of analgesics
  • family history
  • syncope
  • dizziness
  • antecedent retching
  • previous episodes
  • weight loss

Possible signs of an upper GI bleed include:

  • tachycardia
  • pallor
  • sweating
  • low blood pressure, postural drop
  • melaena on digital rectal examination

Also look for the stigmata of liver disease.