Gastrointestinal (GI) bleeding is bleeding in the digestive tract.
The Digestive Tract
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The digestive tract is divided into two sections: the
The upper digestive tract includes the: Esophagus (the muscular tube that transports food from the throat to the stomach)StomachUpper portion of the small intestine
The lower digestive tract includes the: Lower portion of the small intestineLarge intestineAnus
GI bleeding is a potentially serious symptom that requires care from your doctor.
GI bleeding is a symptom caused by several possible conditions. Some of the causes of bleeding include:
In the upper digestive tract: Peptic ulcer
—a sore in the lining of the stomach or the upper portion of the small intestine
—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 cancerous
Cancer—cancer in the
, or small intestine
In the lower digestive tract: Angiodysplasia
—abnormal growth of blood vessels in the intestine
Diverticulum—a pouch that forms on the wall of the large intestine (If the pouch becomes inflamed it is called
—inflammation of the colon (The colon is part of the large intestine.)
—enlarged veins in the anus or rectum
—tears in the anus
Polyps (abnormal growth) or
cancer in the colon
Risk factors include: Alcohol use
Long-term use of steroids, blood-thinning medicine, nonsteroidal anti-inflammatory drugs (NSAIDs), or
aspirinSmokingPrior GI or vascular surgeryHistory of gastrointestinal disease or bleedingHistory of ulcers
History of bacterial infections (
Age (This risk factor is also increased in older patients who take pain medicines.)
If you have any of these symptoms, do not assume they are due to GI bleeding. Other things may cause these symptoms. Tell your doctor if you have:
Upper digestive tract bleeding symptoms: Blood in vomitVomit that looks like coffee groundsBlack, tarry stoolBlood in the stool
Lower digestive tract bleeding symptoms: 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: WeaknessDizziness 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. He will do a physical exam. He will try to find the location and reason for bleeding.
Tests may include:
Blood testsBreath testStool test (to check for blood in the stool)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
Computed tomography (CT) scan
—a type of x-ray that uses a computer to make pictures of structures inside the digestive tract
Nasogastric lavage—a tube placed through the nose and into the stomach removes contents to check for bleedingBarium x-ray
—special x-rays made by having the patient drink a chemical called barium
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
If the doctor is able to figure out the condition causing your bleeding, he will provide you with care to treat it. He may prescribe medicines (eg, proton-pump inhibitors, acid suppressors). You and your doctor will talk about the best treatment plan for you.
Treatment options to stop bleeding at the site include:
Endoscopy can also be used to stop bleeding. With an endoscope (a tube that is placed into the mouth and intestine), the 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 (x-ray of blood vessels) with other tools to locate the bleeding and inject medicines or other materials into the blood vessels to control it.
Sometimes if the doctor has tried other treatments and is unsuccessful, he may consider surgery.
To help reduce your chance of GI bleeding, you will need to reduce the chance of having the conditions that cause it, like: H. pylori
Gastroesophageal reflux disease (GERD)UlcerHemorrhoidsPolypsInflammatory bowel diseases
Discuss these and other possible conditions that may cause GI bleeding with your doctor to find out how to prevent them. You may also want to reduce your use of the following: AlcoholTobaccoNSAIDs (if possible)
Bleeding in the digestive tract. National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
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National Guideline Clearinghouse (NGC). Guideline summary: Management of acute upper and lower gastrointestinal bleeding. A national clinical guideline. In: National Guideline Clearinghouse (NGC) [webite]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [cited 2011 July 18]. Available at:
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Last reviewed September 2012 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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