MedlinePlus Medical Encyclopedia: Gastrointestinal bleeding

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Gastrointestinal bleeding

Contents of this page:
Illustrations Alternative names Definition Considerations	Common Causes Home Care Call your health care provider if What to expect at your health care provider's office

Illustrations

Intussusception - X-ray

Volvulus - X-ray

Alternative names Return to top

Lower GI bleeding; GI bleeding; Upper GI bleeding

Definition Return to top

Gastrointestinal bleeding refers to any bleeding that originates in the gastrointestinal tract, from the mouth to the large bowel. The degree of bleeding can range from nearly undetectable to acute, massive, life-threatening bleeding. Bleeding may originate from any site along the gastrointestinal tract, but is often divided into:

Upper GI bleeding (considered any source located between the mouth and outflow tract of the stomach)
Lower GI bleeding (considered any source located from the outflow tract of the stomach to the anus, small and large bowel included)

Considerations Return to top

Gastrointestinal bleeding can range from microscopic bleeding, where the amount of blood is so small that it can only be detected by laboratory testing, to massive bleeding where pure blood is passed.

It is importnant to be aware of gastrointestinal bleeding, because it may herald many significant diseases and conditions. Prolonged microscopic bleeding can lead to massive losses of iron and subsequent anemia. Acute, massive bleeding can lead to hypovolemia, shock, and even death.

Gastrointestinal bleeding can occur at any age from birth on. The degree and suspected location of the bleeding determines what tests should be performed to find the cause. Once a bleeding site is identified, numerous therapies are available to stop the bleeding.

Common Causes Return to top

Some of the possible causes of gastrointestinal bleeding include:

hemorrhoids
duodenal ulcer
gastric (stomach) ulcer
bleeding diverticulum
ulcerative colitis
Crohn's disease
esophageal varices
arterio-venous malformations
nose bleed
mallory-Weiss tear (tear in esophagus after vomiting)
esophagitis
dysentery (bloody, infectious diarrhea)
ischemic bowel
colon cancer
intestinal polyps
celiac sprue
radiation injury to the bowel
portal hypertensive gastropathy
stomach cancer
intestinal vasculitis
small intestinal cancer
Dieulafoy's lesion
Meckel's diverticulum
Aorto-enteric fistula
cow's milk allergy
intestinal volvulus (twisted bowel)
intussusception (bowel telescoped on itself)
anal fissure

Home Care Return to top

There are home stool tests for microscopic blood that may be recommended for people with anemia or for colon cancer screening.

Call your health care provider if Return to top

You have black, tarry stools (this may be a sign of upper gastrointestinal bleeding).
You have blood in your stools.
You begin vomiting blood or you vomit material that looks like coffee grounds.

What to expect at your health care provider's office Return to top

GI bleeding can be an emergency condition requiring immediate medical attention. Intravenous fluids and medications, blood transfusions, drainage of the stomach through a tube (nasogastric tube), and other measures may be required.

Once the condition is stable, a physical examination, including a detailed abdominal examination, will be performed.

Medical history questions to document GI bleeding in detail may include:

When did it start?
Is it off and on or does it continue?
What did you notice?
Were there black, tarry stools or was there obvious blood in the stools?
Were you vomiting blood?
Did you vomit material that looks like coffee grounds?
Do you have a history of peptic ulcer or duodenal ulcer?
Have you ever had symptoms like this before?
What other symptoms are present?
Did you notice anything that you think may have caused or been associated with the bleeding?

Gastrointestinal bleeding is diagnosed by the health care provider -- the person may or may not have been aware of its presence.

Diagnostic tests may include:

CBC, clotting tests (PT, PTT, INR), platelet count, and other laboratory tests
abdominal X-ray
abdominal CT scan
EGD
colonoscopy
sigmoidoscopy
small bowel enteroscopy
bleeding scan (tagged red blood cell scan)
angiography
abdominal MRI scan
capsule endoscopy (camera pill that is swallowed to see the small intestine)

Update Date: 11/10/2003

Updated by: Christian Stone, M.D., Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.