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K29.0 – Acute Hemorrhagic Gastritis

K29.0 is the ICD-10 code for acute hemorrhagic gastritis, a sudden inflammation of the stomach lining accompanied by bleeding. It requires prompt medical evaluation and treatment.

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Things worth knowing about "K29.0"

K29.0 is the ICD-10 code for acute hemorrhagic gastritis, a sudden inflammation of the stomach lining accompanied by bleeding. It requires prompt medical evaluation and treatment.

What does the ICD-10 code K29.0 mean?

The ICD-10 code K29.0 refers to acute hemorrhagic gastritis. This is a sudden-onset inflammation of the stomach lining (gastritis) that is accompanied by bleeding into or from the mucosal tissue. The term “hemorrhagic” comes from the Greek word for bleeding. This form of gastritis is considered a serious gastrointestinal condition and typically requires prompt medical attention.

Causes

Acute hemorrhagic gastritis can be triggered by a variety of factors:

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or diclofenac: These medications inhibit prostaglandin production, which normally protects the stomach lining.
Alcohol: Excessive alcohol consumption can directly damage the gastric mucosa and lead to bleeding.
Stress: Critically ill patients, for example after major surgery, severe burns, or those in intensive care units, may develop so-called stress gastritis.
Helicobacter pylori infection: The bacterium Helicobacter pylori can cause chronic mucosal damage and acute exacerbations.
Bile reflux: Bile flowing back into the stomach can also cause mucosal injury.

Symptoms

Symptoms of acute hemorrhagic gastritis can vary depending on severity:

Sudden, often intense upper abdominal pain or stomach cramps
Nausea and vomiting, possibly with blood (coffee-ground vomiting indicates older blood)
Melena: black, tarry stools indicating bleeding in the upper gastrointestinal tract
In severe cases: anemia, dizziness, weakness, and circulatory instability
Heartburn or acid regurgitation

Diagnosis

Diagnosis of acute hemorrhagic gastritis is primarily confirmed by esophagogastroduodenoscopy (gastroscopy). During this procedure, a thin, flexible tube with a camera is passed through the mouth into the stomach to directly visualize the mucosal lining. Bleeding sources can be identified and, if necessary, treated at the same time. Additional tests include:

Complete blood count and coagulation parameters to assess the extent of blood loss
Breath test or biopsy to detect a Helicobacter pylori infection
Stool test for occult (hidden) blood

Treatment

Treatment depends on the underlying cause and the severity of bleeding:

Proton pump inhibitors (PPIs): Medications such as omeprazole or pantoprazole reduce gastric acid production and promote mucosal healing.
Endoscopic hemostasis: During gastroscopy, bleeding can be stopped using injection therapy, clips, or thermal coagulation.
Discontinuation of causative medications: NSAIDs and other gastric irritants should be stopped if possible or replaced with stomach-friendlier alternatives.
Helicobacter pylori eradication: If an infection is confirmed, combination therapy with antibiotics and a PPI is used.
Intravenous fluids and blood transfusions: In cases of significant blood loss, hospitalization with fluid resuscitation or transfusion may be necessary.
Avoidance of alcohol and tobacco: These lifestyle changes support mucosal healing and reduce the risk of recurrence.

Prognosis

With timely treatment, acute hemorrhagic gastritis typically heals completely. When causative factors are eliminated, the prognosis is generally good. However, without treatment or with repeated exposure to damaging substances, chronic gastritis or complications such as peptic ulcers may develop.

References

Laine L, Jensen DM. Management of patients with ulcer bleeding. American Journal of Gastroenterology. 2012;107(3):345-360. PubMed PMID: 22310222.
German Institute for Medical Documentation and Information (DIMDI). ICD-10-GM Version 2024 – K29: Gastritis and duodenitis. Federal Ministry of Health, Berlin.
Malfertheiner P, Megraud F, Rokkas T, et al. Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut. 2022;71(9):1724-1762.

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