How does gastrointestinal bleeding happen

You may go into shock if you have acute bleeding. Acute bleeding is an emergency condition. Symptoms of shock include. You may develop anemia if you have chronic bleeding. Symptoms of anemia may include feeling tired and shortness of breath, which can develop over time. Some people may have occult bleeding. Occult bleeding may be a symptom of inflammation or a disease such as colorectal cancer.

A simple lab test can detect occult blood in your stool. Many conditions can cause GI bleeding. A doctor can try to find the cause of your bleeding by finding its source. The following conditions, which are listed in alphabetical order, include possible causes of GI bleeding:. Angiodysplasia is when you have abnormal or enlarged blood vessels in your GI tract. These blood vessels can become fragile and bleed. Benign tumors and cancer.

Benign tumors and cancer in the esophagus , stomach , colon , or rectum may cause bleeding when they weaken the lining of the GI tract. A benign tumor is an abnormal tissue growth that is not cancerous.

Also, seek treatment immediately if you experience any of the following symptoms:. Diagnosis of the underlying cause of your GI bleeding will usually start with your doctor asking about your symptoms and medical history. Your doctor may also request a stool sample to check for the presence of blood along with other tests to check for signs of anemia. Upper GI bleeding is most commonly diagnosed after your doctor performs an endoscopic examination.

Endoscopy is a procedure that involves the use of a small camera located atop a long, flexible endoscopic tube your doctor places down your throat. The scope is then passed through your upper GI tract. The camera allows your doctor to see inside your GI tract and potentially locate the source of your bleeding. Because endoscopy is limited to the upper GI tract, your doctor may perform an enteroscopy.

When inflated, this balloon allows your doctor to open up the intestine and see inside. To determine the cause of lower GI bleeding, your doctor may perform a colonoscopy.

During this test, your doctor will insert a small, flexible tube into your rectum. A camera is attached to the tube so your doctor can view the entire length of your colon. Air moves through the tube to provide a better view. Your doctor may take a biopsy for additional testing. You may also undergo a scan to locate your GI bleeding.

A harmless radioactive tracer will be injected into your veins. Your doctor will have you swallow a pill that contains a small camera that will take pictures of your bowel to find the source of your bleeding. The use of special scopes with cameras and laser attachments, along with medications, can be used to stop the bleeding. In addition, your doctor can use tools alongside scopes to apply clips to the bleeding vessels to stop the bleeding. If hemorrhoids are the cause of your bleeding, over-the-counter OTC treatments might work for you.

Antibiotics can usually treat infections. A bleeding ulcer requires immediate treatment. Learn more about the warning signs and what to expect during treatment. Gastric and duodenal ulcers are both types of peptic ulcers. These ulcers can cause different symptoms, depending on where they are. A peptic ulcer on…. Coffee ground vomitus is vomit that looks like coffee grounds.

This occurs due to the presence of coagulated blood in the vomit. Learn more about this…. Red diarrhea could be caused by many different conditions. The two primary types of inflammatory bowel disease IBD are Crohn Typical symptoms include bleeding during a bowel movement, fatigue, and weakness Other causes of lower GI bleeding include abnormal blood vessels in the colon, a split in the skin of the anus anal fissure Anal Fissure An anal fissure is a tear or ulcer in the lining of the anus the opening at the end of the digestive tract where stool leaves the body.

Anal fissures may occur after passage of hard or large Abdominal pain and bloody stools are common. Computed tomography is usually done, and colonoscopy Bleeding from the small intestine is rare but can result from blood vessel abnormalities, tumors, or a Meckel diverticulum Meckel Diverticulum A Meckel diverticulum is a saclike outpouching of the wall of the small intestine that is present in some children at birth.

Most children do not have symptoms, but sometimes painless rectal Bleeding from any cause is more likely, and potentially more severe, in people who have chronic liver disease Overview of Liver Disease Liver disease can manifest in many different ways.

Characteristic manifestations include Jaundice a yellowish discoloration of the skin and whites of the eyes Cholestasis reduction or stoppage Hemophilia involves an inherited deficiency of certain clotting factors proteins Liver disease makes bleeding more likely because a poorly functioning liver produces fewer of the proteins that help blood clot blood clotting factors Blood clotting factors Hemostasis is the body's way of stopping injured blood vessels from bleeding.

Hemostasis includes clotting of the blood. Too little clotting can cause excessive bleeding from minor injury Too Drugs that can cause or worsen bleeding include anticoagulants such as heparin , warfarin , dabigatran, apixaban , rivaroxaban , and edoxaban , those that affect platelet function such as aspirin and certain other nonsteroidal anti-inflammatory drugs [NSAIDs] and clopidogrel , and those that affect the stomach's protective barrier against acid such as NSAIDs.

GI bleeding typically requires evaluation by a doctor. In people with GI bleeding, certain symptoms and characteristics are cause for concern. They include. Fainting Fainting Light-headedness near syncope is a sense that one is about to faint. Fainting syncope is a sudden, brief loss of consciousness during which the person falls to the ground or slumps in a People who have GI bleeding should see a doctor right away unless the only sign of bleeding is blood on the toilet paper after a bowel movement.

If people with such findings have no warning signs and feel otherwise well, a delay of a day or two is not harmful. Doctors first ask questions about the person's symptoms and medical history.

Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause of the GI bleeding and the tests that may need to be done see Table: Some Causes and Features of Gastrointestinal Bleeding Some Causes and Features of Gastrointestinal Bleeding Bleeding may occur anywhere along the digestive gastrointestinal [GI] tract, from the mouth to the anus.

The history is focused on finding out exactly where the bleeding is coming from, how rapid it is, and what is causing it. Doctors need to know how much blood for instance, a few teaspoons or several clots is being passed and how often blood is being passed. People with hematemesis are asked whether blood was passed the first time they vomited or only after they vomited a few times with no blood. Doctors ask people with rectal bleeding whether pure blood was passed; whether it was mixed with stool, pus, or mucus; or whether blood simply coated the stool.

People with bloody diarrhea are asked about recent travel or other possible forms of exposure to other agents that can cause digestive tract illness for instance, food poisoning.

Doctors then ask about symptoms of abdominal discomfort, weight loss, and easy bleeding or bruising and symptoms of anemia such as weakness, easy exhaustion [fatigability], and dizziness. Doctors need to know about any current or past digestive tract bleeding and the results of any previous colonoscopy examination of the entire large intestine, the rectum, and the anus using a flexible viewing tube. People should tell doctors whether they have inflammatory bowel disease Overview of Inflammatory Bowel Disease IBD In inflammatory bowel diseases, the intestine bowel becomes inflamed, often causing recurring abdominal pain and diarrhea.

Doctors also look for small purplish red petechiae and bruise-like ecchymoses spots on the skin, which are signs of bleeding disorders.

Doctors also look for signs of chronic liver disease such as spider angiomas, fluid in the abdominal cavity [ ascites Ascites Ascites is the accumulation of protein-containing ascitic fluid within the abdomen. Many disorders can cause ascites, but the most common is high blood pressure in the veins that bring blood Cirrhosis scarring that distorts Doctors do a rectal examination to look at stool color and check it for blood and to search for tumors and fissures Anal Fissure An anal fissure is a tear or ulcer in the lining of the anus the opening at the end of the digestive tract where stool leaves the body.

Doctors also examine the anus to look for hemorrhoids Hemorrhoids Hemorrhoids are dilated, twisted blood vessels located in the wall of the lower rectum and anus. The need for tests depends on what doctors find during the history and physical examination, particularly whether warning signs are present.

A low platelet count is a risk factor for bleeding. Other blood tests include prothrombin time PT , partial thromboplastin time PTT , and liver tests, all of which help detect problems with blood clotting. Doctors often do not do blood tests on people who have minor bleeding caused by hemorrhoids.

This procedure may Bloody or pink contents indicate active upper GI bleeding, and dark or coffee-ground material indicates that bleeding is slow or has stopped. Sometimes, there is no sign of blood even though the person was bleeding very recently.

A nasogastric tube may be inserted in anyone who has not vomited but has passed a large amount of blood from the rectum if not from an obvious hemorrhoid because this blood may have originated in the upper digestive tract.

Upper endoscopy Endoscopy Endoscopy is an examination of internal structures using a flexible viewing tube endoscope. Endoscopy can also be used to treat many disorders because doctors are able to pass instruments An upper endoscopy allows the doctor to see the bleeding source and often treat it and is often done without a nasogastric tube being passed.

People with symptoms typical of hemorrhoids may need only sigmoidoscopy examination of the lower part of the large intestine, the rectum, and anus using an endoscope. All other people with hematochezia should have colonoscopy examination of the entire large intestine, the rectum, and the anus using an endoscope. Occasionally, endoscopy both upper and lower and colonoscopy do not show the cause of bleeding. There are still other options for finding the source of the bleeding.

Doctors may do endoscopy of the small bowel enteroscopy. If bleeding is rapid or severe, doctors sometimes do angiography Angiography In angiography, x-rays are used to produce detailed images of blood vessels. It is sometimes called conventional angiography to distinguish it from computed tomography CT angiography and magnetic