Oesophageal carcinoma [top]

  • Progressive dysphagia to liquids then solids which stick in throat
  • Epigastric pain
  • Weight loss
  • Vomiting, haematemesis, melaena

Hiatus hernia [top]

  • Vomiting after heavy meal
  • Epigastric pain
  • Worse on lying flat
  • Reflux, occasional haematemesis

Gastric ulcer or erosion [top]

  • Burning epigastric pain
  • Worsened by food
  • Vomiting after eating, Weight loss
  • Consumption of NSAIDs or excessive alchohol
  • Haematemesis or melaena if bleeding

Epistaxis [top]

  • Can be mistaken for haematemesis

Mallory-Weiss tear [top]

  • Vomiting followed by regurgitation of bright red blood haematemesis

Bleeding duodenal ulcer [top]

  • Haematemesis or melaena
  • Epigastric pain; preceding history of recurrent epigastric pain

Oesophageal varices [top]

  • Severe haematemesis, melaena
  • Hypotension, tachycardia
  • Signs of decompensated liver diseaseHistory of excessive alcohol consumption or chronic liver disease

Gastric carcinoma [top]

  • Epigastric pain
  • Persistent vomiting, haematemesis, melaena
  • Weight loss
  • Early saiety
  • Troisier's sign - palpable supraclavicular lymph node

Gastro-oesophageal reflux [top]

  • Central chest pain or Epigastric pain
  • Burning
  • Recurrent episodes
  • Worse on lying down
  • Acid reflux, occasional haematemesis
  • Relieved by antacids
  • Belching
  • Persistent cough

Duodenal ulcer [top]

  • Burning epigastric pain
  • Relieved by food
  • Vomiting after eating, weight loss
  • Haematemesis or melaena if bleeding

Haemoptysis [top]

  • Can be mistaken for haematemesis