GI Bleed, Peptic Ulcer Disease & Cirrhosis/Liver Failure

Upper GI bleeding presents with hematemesis (vomiting blood, which may look like coffee grounds if partially digested) and melena (black, tarry, foul-smelling stool); lower GI bleeding more often presents as hematochezia (bright red blood per rectum). Peptic ulcer disease is commonly caused by H. pylori infection or long-term NSAID use, and a sudden, severe, "worst pain of my life" abdominal pain with a rigid, board-like abdomen suggests perforation — a surgical emergency, not a medication-management situation. Treatment for active GI bleeding prioritizes airway/breathing/circulation first (IV access, fluid/blood replacement as needed) before diagnostic workup, since hemodynamic stability always comes before identifying the exact source.