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 stomachStomachUpper portion of the small intestine
The lower digestive tract includes the: Lower portion of the small intestineLarge 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 esophagusGastritis—inflammation and ulcers in the lining of the stomach
Esophagitis—inflammation and ulcers in the lining of the esophagusBenign tumors—abnormal tissue growth that is not cancerousStomach arteriovenous malformations
Cancer—cancer in the
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 intestineDiverticulitis—occurs when the pouch becomes inflamed
Inflammatory bowel diseaseHemorrhoids
—enlarged veins in the rectum and/or anusFissures—tears in the anus
Factors that may increase your chance of GI bleeding include: Bleeding disorders (some more than other)Alcohol use disorderLong-term use of steroids, blood-thinning medication, nonsteroidal anti-inflammatory drugs (NSAIDs), or aspirinSmokingPrior GI or vascular surgeryHistory of gastrointestinal disease or bleedingHistory of ulcers
History of bacterial infections, such as
Upper digestive tract bleeding symptoms may include: Blood in vomitVomit that looks like coffee groundsBlack, tarry stoolBlood in the stool
Lower digestive tract bleeding symptoms may include: Black, tarry stoolBlood in the stool
It may be difficult to notice small amounts of blood in the stool. Your doctor can do
to detect this.
Sometimes, bleeding can occur suddenly and be severe. You may notice symptoms like: WeaknessLightheadedness or faintnessShortness of breathAbdominal painDiarrheaPaleness
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 testsBreath testStool test to check for bloodUpper GI endoscopy—a thin, lighted tube inserted down the throat to examine the digestive tract and collect tissue samplesColonoscopy—a thin, lighted tube inserted through the rectum and into the colon to examine the lining of the colon
—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 bleedingBarium 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 tractAngiography
—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
Vasoconstrictors to reduce bleedingCorticosteroids to reduce inflammationProbiotics 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 siteUsing a heat probe, electric current, or laser to seal off the bleeding siteUsing 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
or uncontrolled bleeding.
To help reduce your chance of gastrointestinal bleeding:
Follow treatment plans for any gastrointestinal conditionsReduce your intake of alcohol or NSAIDs if possibleIf you smoke, talk with your doctor about how you can quit
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Last reviewed June 2016 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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