Gastrointestinal (GI) bleeding is bleeding in the digestive tract.
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The digestive tract is divided into 2 sections. The upper digestive tract includes the:
- Esophagus—the muscular tube that transports food from the throat to the stomach
- Upper portion of the small intestine
The lower digestive tract includes the:
- Lower portion of the small intestine
- Large intestine
- Rectum and anus
GI bleeding is a potentially serious symptom that requires care from your doctor.
GI bleeding is a symptom caused by many possible conditions.
Causes in the upper digestive tract may include:
- Peptic ulcer—a sore in the lining of the stomach or the upper portion of the small intestine
- Esophageal varices—abnormally swollen veins within the lining of the esophagus
- Mallory-Weiss tears—tears in the lining of the esophagus
- Gastritis—inflammation and ulcers in the lining of the stomach
- Esophagitis—inflammation and ulcers in the lining of the esophagus
- Benign tumors—abnormal tissue growth that is not cancerous
- Stomach arteriovenous malformations
- Cancer—cancer in the esophagus, stomach, or small intestine
Causes in the lower digestive tract may include:
- Angiodysplasia—abnormal growth of blood vessels in the intestine
- Diverticulum—a pouch that forms on the wall of the large intestine
- Diverticulitis—occurs when the pouch becomes inflamed
- Inflammatory bowel disease
- Hemorrhoids —enlarged veins in the rectum and/or anus
- Fissures—tears in the anus
- Polyps or colon cancer
Factors that may increase your chance of GI bleeding include:
- Bleeding disorders (some more than other)
- Alcohol use disorder
- Long-term use of steroids, blood-thinning medication, nonsteroidal anti-inflammatory drugs (NSAIDs), or aspirin
- Prior GI or vascular surgery
- History of gastrointestinal disease or bleeding
- History of ulcers
- History of bacterial infections, such as Helicobacter pylori
Upper digestive tract bleeding symptoms may include:
- Blood in vomit
- Vomit that looks like coffee grounds
- Black, tarry stool
- Blood in the stool
Lower digestive tract bleeding symptoms may include:
- Black, tarry stool
- Blood in the stool
It may be difficult to notice small amounts of blood in the stool. Your doctor can do tests to detect this.
Sometimes, bleeding can occur suddenly and be severe. You may notice symptoms like:
- Lightheadedness or faintness
- Shortness of breath
- Abdominal pain
Bleeding that is light and occurs over a long period of time may make you feel tired and short of breath.
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include:
- Blood tests
- Breath test
- Stool test to check for blood
- Upper GI endoscopy—a thin, lighted tube inserted down the throat to examine the digestive tract and collect tissue samples
- Colonoscopy—a thin, lighted tube inserted through the rectum and into the colon to examine the lining of the colon
- CT scan —a type of x-ray that uses a computer to make pictures of structures inside the digestive tract
- Nasogastric aspiration—a tube placed through the nose and into the stomach removes contents to check for bleeding
- Barium x-ray —x-ray that uses contrast material to see internal structures
- Radionuclide scanning—the use of small amounts of radioactive material and a camera to create blood flow images of the digestive tract
- Angiography —an x-ray of the blood vessels
Treatment will depend on the cause of the bleeding. Your doctor may switch your medications or stop certain ones if it is suspected as the cause of your GI bleeding. You may need to make some lifestyle changes.
Other treatments may include:
Your doctor may advise medications depending on your symptoms or the results of your tests. Examples include:
- Proton pump inhibitors (PPIs) or H-2 blockers to reduce stomach acid production
- Antibiotics to treat bacterial infections
- Vasoconstrictors to reduce bleeding
- Corticosteroids to reduce inflammation
- Probiotics to introduce healthy bacteria into the GI tract
Some treatments are more effective with a combination of medications.
Endoscopy can also be used to stop bleeding. With an endoscope, your doctor can stop the bleeding by:
- Injecting chemicals into the bleeding site
- Using a heat probe, electric current, or laser to seal off the bleeding site
- Using a band or clip to close off blood vessels
Angiography, which is also used as a diagnostic tool, can control bleeding. The doctor can use angiography with other tools to locate the bleeding and inject medications or other materials into the blood vessels to control it.
If other treatment options fail, your doctor may recommend surgery. Surgery may be necessary for some conditions, such as diverticulitis or uncontrolled bleeding.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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a (GI Bleeding; Bleeding, Gastrointestinal; Bleeding, GI)
American College of Gastroenterology http://gi.org
American Gastroenterological Association http://www.gastro.org
Canadian Association of Gastroenterology https://www.cag-acg.org
Health Canada http://www.hc-sc.gc.ca
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