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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
- 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.
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:
- Angiodysplasia —abnormal growth of blood vessels in the intestine
- Diverticulum—a pouch that forms on the wall of the large intestine
- Diverticulitis —happens when the pouch becomes inflamed
- Inflammatory bowel diseases
- Hemorrhoids —enlarged veins in the rectum or anus
- Fissures —tears in the anus
- Polyps , or cancer in the colon , rectum , or anus
Your chances of GI bleeding are higher for:
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
- Pale skin
Bleeding that is light and happens over a long period of time may make you feel tired and cause breathing problems.
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 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.
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 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 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 may be used when other methods fail. It may be needed to treat some conditions such as diverticulitis or uncontrolled bleeding.
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.
American College of Gastroenterology
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
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- Reviewer: EBSCO Medical Review Board Daus Mahnke, MD
- Review Date: 05/2018
- Update Date: 08/15/2018