What Is Gastrointestinal Bleeding?

Gastrointestinal (or GI) bleeding is blood loss that occurs in any of the organs that make up your digestive tract. Your GI system extends from your mouth and esophagus through your stomach and intestines to the rectum and anus. GI bleeding can be overt (visible) or occult (hidden). The seriousness of this blood loss varies with location and degree but is in any case a cause for concern. In extreme situations, GI bleeding is treated as a medical emergency.

The causes and symptoms of gastrointestinal blood loss are dependent on a number of factors. If you or a loved one have symptoms of GI bleeding anywhere in the body, the gastroenterology team at Baptist Health is ready to see you.

Causes

Physicians generally group the organs of the digestive tract into upper and lower regions. The organs of the upper digestive tract include the oral cavity, esophagus, stomach, and small intestines. Causes of bleeding in the upper GI include:

• Esophageal varices: These are ruptured blood vessels in the esophagus.
• Mallory-Weiss syndrome: Frequent vomiting can result in damage to the esophageal walls. The medical name for this condition is Mallory-Weiss syndrome.
• Gastroesophageal reflux disease (GERD): Acid reflux occurs when digestive acids rise from the stomach into the throat. A person with GERD suffers regularly from acid reflux.
• Ulcers: Ulcers are open sores that form in the stomach or the upper part of the small intestines (the duodenum).
• Gastritis: Gastritis is an inflammation of the stomach.
• Duodenitis: An inflammation of the upper small intestines is called duodenitis.
• Enlarged blood vessels: Enlarged or distended blood vessels can be a source of bleeding. The medical condition is called angiodysplasia.
• Cancerous tumors: Cancers in any of the organs of the upper GI tract can result in bleeding, including the esophagus, pancreas, liver, and stomach.

The lower GI is comprised of the large intestines, rectum, and anus. Causes of blood loss in the lower digestive tract include:

• Inflammatory bowel disease (IBD): IBD is an inflammation of the small intestines and colon. The principal causes of IBD are two chronic medical conditions: ulcerative colitis and Crohn’s disease.
• Diverticulitis: This is an inflammatory condition of the lower digestive tract, in which small pockets of the colon called diverticula become excessively irritated. This irritation can damage vessels and generate blood loss.
• Hemorrhoids: Hemorrhoids are ruptured veins of the rectum or anus.
• Rectal ulcers: Open sores forming in the rectum can result in GI bleeding.
• Anal fissures: An anal fissure is a tear in the sphincter muscle. Blood loss from this condition is evident in stool.
• Cancerous tumors: Colorectal and anal cancers can cause bleeding in the lower GI tract.

Several factors can increase the risk of GI bleeding. These include:

• Smoking
• Alcohol consumption
• Use of non-steroidal anti-inflammatory (NSAID) medications, such as aspirin, naproxen, or ibuprofen

Symptoms

Some symptoms of gastrointestinal bleeding are plainly visible; others are hidden or harder to detect. Overt or obvious symptoms include:

• Coughing up or vomiting blood
• Rectal bleeding
• Bloody stools (either red or black)

Hidden or occult bleeding is suggested by:

• Feeling lightheaded
• Labored breathing
• Pain in the chest or abdomen
• Passing out

In the most serious cases, you may experience the symptoms of shock. These include extreme fatigue, nausea, clammy skin, a rising heart rate, falling blood pressure, discoloration of the extremities, and dilated pupils. If you exhibit shock symptoms, call 9-1-1 or have someone take you immediately to the nearest medical emergency facility.

Diagnosing

The diagnosis of gastrointestinal bleeding is most often undertaken by a gastroenterologist, a specialist in medical conditions of the digestive tract. Because GI bleeding has a variety of potential causes, the diagnostic process contains several possible steps. On your first visit, your physician will ask you questions about your symptoms and document your answers. He or she may also ask about your family medical history.

If evidence suggests that your problem is located in the upper GI tract, he or she may order the following tests:

• Blood test: By analyzing a sample of your blood, a physician can sometimes identify evidence of internal bleeding, such as anemia.
• Endoscopy: An endoscope is a tiny camera with a light that a gastroenterologist inserts into your stomach or small intestines by means of a long flexible tube through your mouth. He or she uses this camera to inspect for evidence of a medical condition. Though not a surgical procedure, endoscopy typically requires some type of anesthesia.
• Enteroscopy: Enteroscopy is similar to endoscopy with the addition of an inflatable, balloon-like structure mounted on the tip of camera tube. The balloon is inflated inside the body to increase the camera’s field of vision. Enteroscopy is utilized when an endoscopic procedure fails to locate a source of bleeding.

If evidence points to a problem of the lower GI, your physician may conduct one or more of these procedures:

• Stool test: A stool test can sometimes help pinpoint the source of occult bleeding in the gastrointestinal tract.
• Colonoscopy: A colonoscopy is an endoscopic procedure for the colon. Your physician will use a slender, camera-tipped tube to inspect your colon for blood loss, entering through the rectum. He or she may also collect a small tissue sample for a biopsy. A biopsy is a lab-conducted examination of tissue for evidence of disease. Biopsies are used to identify a number of medical conditions, including cancer.
• Imaging scans: Your physician may produce interior images of your lower GI using either X-ray or computed tomography (CT) technology. The injection of a nontoxic radioactive dye into your bloodstream can increase the visibility of blood loss in the scans.
• Capsule endoscopy: A capsule endoscopy is a variation on the normal endoscopic process. The camera is contained in a small capsule, which you swallow prior to the procedure. The capsule will take pictures of your lower GI tract as it passes through your digestive system.

How Is Gastrointestinal Bleeding Treated?

Treatments of gastrointestinal bleeding vary, based on the nature and location of the medical issue. There are two primary means of treating less-urgent forms of blood loss:

• Medications for GERD, hemorrhoids, or ulcers
• Endoscopic procedures for sealing blood vessels, injecting coagulants, or removing polyps or potentially cancerous growths

Bleeding that results from chronic conditions, such as irritable bowel syndrome, or potentially life-threatening conditions, such as cancer, involves more intensive forms of medical care. Under certain circumstances, internal blood loss, if left untreated, can result in major illness and death.

How Long Does It Take to Recover from Gastrointestinal Bleeding?

Many people suffering from GI bleeding undergo a complete recovery over time. Proper diagnosis and treatment of the condition is important. If bleeding is a consequence of a more serious condition such as cancer, an individual’s long-term prognosis will depend on the success of the treatments for that particular medical condition.

When to See a Doctor About Gastrointestinal Bleeding

Gastrointestinal bleeding is blood loss that originates anywhere in the digestive tract. It has a variety of causes and symptoms, some of which are apparent and some of which are not. If you think that you have indications of digestive-tract bleeding, find a local Baptist Health doctor near you today!