Gastrointestinal Bleeding

Definition

Gastrointestinal (GI) bleeding is bleeding in the digestive tract.

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The upper digestive tract is the:

  • Esophagus—the tube that moves food from the mouth to the stomach
  • Stomach
  • Upper part of the small intestine

The lower digestive tract is the:

  • Lower part of the small intestine
  • Large intestine
  • Rectum and anus

GI bleeding can be a life-threatening problem that needs care right away.

Causes

GI bleeding has many causes.

Causes in the upper digestive tract:

  • Peptic ulcer—a sore in the lining of the stomach or the part of the small intestine
  • Esophageal varices—swollen veins in the esophageal lining
  • Mallory-Weiss tears—tears in the esophageal lining
  • Gastritis—inflammation and sores in the stomach lining
  • Esophagitis—inflammation and sores in the esophageal lining
  • Benign tumors—noncancerous growths
  • Stomach arteriovenous malformations
  • Cancer in the esophagus, stomach, or small intestine

Causes in the lower digestive tract:

Risk Factors

Your chances of GI bleeding are higher for:

  • Having bleeding problems
  • Alcohol use disorder
  • Long term use of steroids, blood thinners, nonsteroidal anti-inflammatory drugs (NSAIDs), or aspirin
  • Smoking
  • Prior GI or vascular surgery
  • Prior GI disease or bleeding
  • Prior ulcers
  • Prior infections such as Helicobacter pylori

Symptoms

Upper digestive tract bleeding may cause:

  • Blood in vomit
  • Vomit that looks like coffee grounds
  • Black, tarry stool
  • Blood in the stool

Lower digestive tract bleeding may cause:

  • Black, tarry stool
  • Blood in the stool

You many not see small amounts of blood in the stool. Your doctor can find it with testing.

Sometimes, bleeding can happen rapidly and be severe. This may cause:

  • Feeling weak
  • Lightheadedness or faintness
  • Breathing problems
  • Belly pain
  • Diarrhea
  • Pale skin

Bleeding that is light and happens over a long period of time may make you feel tired and cause breathing problems.

Diagnosis

Your doctor will ask about your symptoms and health history.

You may have:

  • A physical exam
  • Blood tests
  • Breath test
  • Stool test to check for blood
  • Upper GI endoscopy—a thin, lighted tube is placed in the mouth and moved into the stomach and upper part of the small intestine
  • Colonoscopy—a thin, lighted tube is placed in the anus and moved into the rectum and large intestine
  • CT scan
  • A nasogastric tube placed through the nose and into the stomach
  • Barium x-ray—contrast material is swallowed or used as an enema to see structures
  • Radionuclide scanning—to see how blood flows through the GI tract
  • Angiography—to see the blood vessels

Treatment

Treatment depends on what's causing the bleeding. If medicines are causing problems, your doctor may stop or change them. You may need to make lifestyle changes.

Medicines

The type you need depends on what is causing problems. They're used to:

  • Lower the amount of acid the stomach makes
  • Treat bacterial infections
  • Lessen bleeding
  • Lessen inflammation
  • Place healthy bacteria into the GI tract—probiotics

For some people, more than one type may be needed.

Endoscopy

Endoscopy can also be used to stop 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

Angiography can also be used to control bleeding. Other tools are used to find the bleeding. Medicines or other materials are injected into the blood vessels to control it.

Surgery

Surgery may be used when other methods fail. It may be needed to treat some conditions such as diverticulitis or uncontrolled bleeding.

Prevention

To help lower your chances of GI bleeding:

  • If you have a GI problem, treat it as advised by your doctor.
  • Don't drink alcohol. If you do, drink in moderation. Moderation is 2 drinks a day or less for men and 1 drink a day or less for women.
  • Use NSAIDs as advised or try to avoid them completely.
  • Quit smoking. Your doctor will help you find the best way to do this.

Revisions

  • EBSCO Medical Review Board Daus Mahnke, MD
  • Reviewed: 06/2018
  • Updated: 08/15/2018

Please note, not all procedures included in this resource library are available at Henry Ford Allegiance Health or performed by Henry Ford Allegiance Health physicians.

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