What is a common symptom of an upper gastrointestinal bleed?

A common symptom of an upper gastrointestinal bleed is melena, which refers to black, tarry stools. This occurs because the blood from the upper gastrointestinal tract (esophagus, stomach, or the first part of the small intestine) is digested as it passes through the intestines, giving it a characteristic dark color. The presence of melena is a crucial indicator that there has been bleeding above the level of the colon, which can stem from various causes, such as peptic ulcers, varices, or gastritis.

In contrast, hematochezia—often associated with lower gastrointestinal bleeding—refers to the passage of fresh, red blood in the stool and is not characteristic of upper GI bleeds. Hematuria relates to blood in the urine, which is unrelated to gastrointestinal bleeding. Hypotension can occur as a result of significant blood loss from any source, including upper GI bleeding, but it is a more general symptom and not specific to the upper gastrointestinal tract itself. Thus, melena stands out as the key symptom indicative of an upper GI bleed.