Bleeding spots and erosions visible in the mucosa of the distal small intestine may be caused by inflammatory diseases of the small intestine such as intestinal tuberculosis, Crohn’s disease, bacterial enteritis, etc., which can cause epigastric pain. 1. Intestinal tuberculosis: it is a chronic specific infectious disease caused by Mycobacterium tuberculosis invading the intestinal tract, and pulmonary tuberculosis is a common primary lesion, which is mainly infected through the mouth, and can also be caused by hematogenous dissemination, direct spread, etc. The symptoms include abdominal pain, bowel habitual bleeding and erosion. The manifestations are abdominal pain, change of bowel habit, fever, malaise and so on. 2. Crohn’s disease: a chronic granulomatous disease of the digestive tract of unknown cause, from the mouth to the anus of the digestive tract can be involved, mostly in the end of the ileum and neighboring colon. The main symptoms are abdominal pain, diarrhea, weight loss and so on. 3. Bacterial enteritis: enteritis caused by bacterial infection, clinical symptoms include abdominal pain, diarrhea, fever, and a sense of urgency and gravity, etc. It is mostly seen in children and hospitalized patients. Bleeding spots and erosion of the mucosa of the distal small intestine can also be seen in viral enteritis, etc., which can also cause epigastric pain, and it is recommended to consult a doctor in time to clarify the diagnosis and carry out targeted treatment.