Gastrointestinal (GI) bleeding is a symptom of a disorder in the digestive tract. The GI tract includes the esophagus, stomach, small intestine, large intestine (colon), rectum and anus.

The blood from GI bleeding can often appear in stool or vomit but it is not always visible. However, the amount of bleeding can range from mild to severe and life threatening.

The causes of GI bleeding are categorized into upper or lower bleeding relative to their location in the GI tract.  Sophisticated imaging technology can help locate the problem, which can be fixed with minimally invasive procedures.

 

Symptoms

Acute GI bleeding initially occurs as vomiting blood, bloody bowel movements or black, tarry stools. Symptoms associated with blood loss include:

 

  • Fatigue
  • Weakness
  • Shortness of breath
  • Abdominal pain
  • Pale appearance
  • Anemia

 

Symptoms of bleeding in the upper digestive tract

 

  • Vomiting bright red blood
  • Vomit that looks like coffee grounds
  • Black or tarry stool
  • Dark blood mixed with stool

 

Symptoms of bleeding in the lower digestive tract

 

  • Black or tarry stool
  • Dark blood mixed with stool
  • Stool mixed or coated with bright red blood

 

Causes

The causes of gastrointestinal bleeding are also categorized into upper or lower causes relative to the location of the bleeding.

 

Causes of upper GI bleeding

 

  • Peptic ulcer disease: Peptic ulcers cause erosions of the mucosal lining of the digestive tract, which damages the blood vessels and leads to bleeding.
  • Gastritis: Inflammation of the stomach lining that can lead to bleeding.
  • Esophageal varices: Swelling of the veins of the esophagus or stomach that typically result from liver disease. Bleeding may be severe.
  • Cancer: Early signs of esophageal or stomach cancers may be blood in the vomit or stool.
  • Mallory-Weiss tear: A tear in the esophageal or stomach lining that is often the result of vomiting or retching.
  • Inflammation: Stomach acid may affect the stomach due to breakdown of the mucous membranes in the stomach and lead to inflammation and bleeding.

 

Causes of lower GI bleeding

 

  • Diverticulosis: Small out-pockets or diverticula that form in the wall of the colon, especially in weakened areas of the bowel wall.
  • Cancers: Early signs of colon or rectal cancers may be blood in the stool.
  • Infectious diarrhea: Damage to the inner lining of the intestines due to viruses or bacteria.
  • Inflammatory bowel disease (IBD): Flares of inflammation that can lead to stool mixed with blood and mucous.
  • Angiodysplasia: Malformation of the blood vessels in the wall of the GI tract, more commonly in the large intestine.
  • Polyps: Noncancerous tumors of the GI tract that may cause rapid bleeding.
  • Hemorrhoids and fissures: Hemorrhoids are swollen veins in and around the anus that may bleed due to straining during bowel movements. Anal fissures are tears in the anal wall that may cause small bleeding.

 

Prevention

 

  • Avoid foods, alcohol and smoking that increase gastric secretions
  • High-fiber diet to increase the bulk of the stool, which helps prevent diverticulosis and hemorrhoids