GI bleeding

Blood in vomit or stool can be a sign of gastrointestinal (GI) bleeding. GI bleeding can be scary, though the cause of the bleeding may not be serious. You should always see a doctor if GI bleeding occurs.

The GI tract

The GI tract is the path through which food travels in the body. Food passes from the mouth down the esophagus (the tube from the mouth to the stomach). Food begins to break down in the stomach. It then moves through the duodenum, the first part of the small intestine. Nutrients are absorbed as food travels through the small intestine. What is left passes into the colon (large intestine) as waste. The colon removes water from the waste. Waste continues from the colon to the rectum (where stool is stored). Waste then leaves the body through the anus.

Causes of GI bleeding

GI bleeding can be caused by many different problems. Some of the more common causes include:

  • Hemorrhoids (swollen veins in the anus)

  • Varices (swollen veins in the esophagus)

  • Ulcer (sore on the lining of the GI tract)

  • Cuts or scrapes in the mouth or throat

  • Infection (bacteria or parasites)

  • Food allergies, such as gluten

  • Medications

  • Inflammation (swelling or irritation of the lining of the GI tract, such as gastritis or esophagitis)

  • Colitis (Crohn's disease or ulcerative colitis)

  • Cancer (tumors or polyps)

  • Diverticula (abnormal pouches in the colon)

  • Tears in the esophagus or anus

  • Nosebleed

  • Angiodysplasia, abnormal blood vessels in the GI tract

Diagnosing the cause of blood in stool

If blood is coming out in your stool, it may signal a lower GI tract problem. Bleeding from the GI tract can be bright red, or it may look dark and tarry. Occult blood can’t be seen with the eye, but can be found in the stool on tests. To determine the cause, tests that may be ordered include:

  • Blood tests

  • Hemoccult test: checks a stool sample for blood

  • Stool culture: checks a stool sample for bacteria or parasites

  • X-ray, ultrasound, or CT scan: imaging tests that take pictures of the digestive tract

  • Colonoscopy or sigmoidoscopy: a test during which a flexible tube with a camera is inserted through the anus into the rectum to view the inside of your colon. This lets the doctor do a biopsy (take a tiny tissue sample and treat a bleeding source).

Diagnosing the cause of blood in vomit

Vomiting blood or a coffee ground material may signal an upper GI tract problem. To find the cause, tests that may be done include:

  • Upper Endoscopy: a test during which a flexible tube with a camera is inserted through the mouth and throat to see inside the upper GI tract. This lets the doctor do a biopsy (take a tiny tissue sample and treat a bleeding source).

  • Nasogastric lavage: which can distinguish upper versus lower GI bleeding

  • X-ray, ultrasound, or CT scan: tests that take pictures of the digestive tract

  • Upper GI series: X-rays of the upper part of the GI tract taken from inside the body

  • Enteroscopy: sending a flexible tube or a small, swallowed capsule camer into the small intestine

Call your health care provider right away if you have any of the following:

  • Bleeding from the mouth or anus that can’t be stopped

  • Fever of 100.4°F (38.0°) or higher

  • Bleeding accompanied by lightheadedness or dizziness

  • Signs of dehydration (dry, sticky mouth; decreased urine output; very dark urine)

  • Abdominal pain

Treatments

Most cases of GI bleeding can be treated. Your plan will depend on the exact location of the bleeding and what’s causing it. Treatments can differ for upper and lower gastrointestinal bleeding, but endoscopy is the most common treatment option regardless of the location.

The endoscope can be inserted through the mouth or through the anus to inject chemicals, use heat to cauterize the site or place a clip to stop the bleeding. Medication is often prescribed to prevent further bleeding.

If endoscopy treatment is not successful in stopping the bleeding, surgery may be necessary.

Once the bleeding is under control, your doctor will need to determine what treatment you need (such as medicine) to keep it from coming back.

If the GI bleeding is severe, hospitalization may be needed to quickly treat the blood loss and prevent low blood pressure or shock. Treatment in that situation would include IV fluids and close monitoring of your blood count. A blood transfusion might be necessary.

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Treatments for GI bleeding

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Symptoms and Screenings for GI bleeding

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Causes and Preventions for GI bleeding

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Education and Resources for GI bleeding

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Support groups for GI bleeding

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