Signs and symptoms of GI bleeding can be either obvious (overt) or hidden (occult). Signs and symptoms depend on the location of the bleed, which can be anywhere on the GI tract, from where it starts — the mouth — to where it ends — the anus — and the rate of bleeding.
Shock — GI bleeds that come on quickly and progress rapidly can lead to a lack of blood flow to the rest of the body, damaging organs and causing organ failure. Without treatment, shock can worsen, causing irreversible damage or even death.
Doctors most often use upper GI endoscopy and colonoscopy to test for acute GI bleeding in the upper and lower GI tracts. Upper GI endoscopy. In an upper GI endoscopy, your doctor feeds an endoscope down your esophagus and into your stomach and duodenum.
Internal bleeding may be much more difficult to identify. It may not be evident for many hours after it begins, and symptoms may only occur when there is significant blood loss or if a blood clot is large enough to compress an organ and prevent it from functioning properly.
There are many possible causes of GI bleeding, including hemorrhoids, peptic ulcers, tears or inflammation in the esophagus, diverticulosis and diverticulitis, ulcerative colitis and Crohn's disease, colonic polyps, or cancer in the colon, stomach or esophagus.
Often, GI bleeding stops on its own. If it doesn't, treatment depends on where the bleed is from. In many cases, medication or a procedure to control the bleeding can be given during some tests.
Acute GI bleeding is sudden and can sometimes be severe. Chronic GI bleeding is slight bleeding that can last a long time or may come and go.
Most patients with GI bleeding will require hospitalization. However, some young, healthy patients with self-limited and asymptomatic bleeding may be safely discharged and evaluated on an outpatient basis.
Avoid or limit caffeine and spicy foods. Also avoid foods that cause heartburn, nausea, or diarrhea.
Drugs that can lead to gastrointestinal bleeding include non-steroidal anti-inflammatory drugs (NSAIDs) like diclofenac and ibuprofen, platelet inhibitors such as acetylsalicylic acid (ASS), clopidogrel and prasugrel, as well as anticoagulants like vitamin-K antagonists, heparin or direct oral anticoagulants (DOAKs).
CT can aid in identifying the location and cause of bleeding and is an important complementary tool to endoscopy, nuclear medicine, and conventional angiography in evaluating patients with GI bleeding.
The most common primary sites of upper GIT metastases leading to upper GIB include melanoma, lung, pancreas, breast and colorectal. Endoscopy is frequently used to evaluate the etiology of an upper GIB and can often assist in making the diagnosis of a potential malignancy.
The most common cause of lower GI bleeds in patients younger than 50 years is anorectal disorders, specifically, hemorrhoids. Inflammatory bowel disease (IBD) and NSAID use should also be evaluated in lower GI bleeds.
Internal bleeding can be sudden and rapid with extreme pain, shock, and fainting. Or, it can be slow and "silent" with few symptoms until the total loss of blood is extreme. Although, symptoms don't always reflect the amount of bleeding and its severity.
There are many causes of lower GI bleeding in the elderly. The most common causes of lower GI bleeding are diverticular disease and vascular ectasias.
Common benign (non-serious) causes — If you see a small amount of bright red blood on the toilet paper after wiping, on the outside of your stool, or in the toilet, this may be caused by hemorrhoids or an anal fissure. Both of these conditions are benign, and there are treatments that can help.
Clinical presentations of gastrointestinal bleeding are classified as overt (acute), occult (chronic) or obscure and the corresponding diagnostic algorithms are illustrated through review of the key evidence and consensus guidelines. Upper endoscopy and colonoscopy are the mainstay of initial investigations.
You may start vomiting blood or “coffee grounds” or you might have dark, tarry stools. In addition you may have: Abdominal pain.