Gastrointestinal (GI) bleeding 

Overview  

Gastrointestinal (GI) bleeding occurs when there is an issue within your digestive tract. The symptoms of bleeding in the digestive tract vary based on the location and seriousness of the bleeding. When blood originates from the rectum or lower colon, it will either coat the stool or mix with it, resulting in a bright red coloration. While the cause of bleeding might not always be of a critical nature, it is crucial to identify its source. The GI tract includes the esophagus, stomach, small intestine, large intestine or colon, rectum and anus.The extent of bleeding can range from mild to severe and could potentially be life–threatening. 

In cases where necessary, advanced imaging technology is generally effective in pinpointing the root cause of the bleeding. The course of treatment is determined by identifying the specific source of the bleeding.  

Symptoms  

GI bleeding can exhibit evident signs (overt) or remain concealed (occult). These signs and symptoms vary depending on the location of the bleed within the GI tract – starting from the mouth and terminating at the anus – as well as its severity.  

Visible Bleeding (Overt): 

• Vomiting Blood: It could be red or dark brown, resembling coffee grounds. 
• Black, Tarry Stool: Stool may appear black and sticky. 
• Rectal Bleeding: Blood might be seen in or with stool. 

Hidden Bleeding (Occult): 

• Lightheadedness: Feeling dizzy or faint. 
• Difficulty Breathing: Breathlessness or trouble taking deep breaths. 
• Fainting: Suddenly losing consciousness. 
• Chest Pain: Pain or discomfort in the chest area. 
• Abdominal Pain: Pain or discomfort in the stomach area. 

The sudden and rapid onset of bleeding can potentially lead to a state of shock. If you or someone else experiences symptoms of shock, it is crucial to call your local emergency medical number without delay. Shock can be identified by the following signs and symptoms: 

• A decrease in blood pressure 
• Infrequent or very limited urination 
• Rapid heartbeat 
• Loss of consciousness 

Causes 

Causes of upper GI bleeding  

• Peptic ulcers: the primary culprit behind upper gastrointestinal bleeding, are lesions that develop on the lining of the stomach and upper small intestine. These sores arise due to stomach acid damage caused by bacteria or the use of anti–inflammatory medications. 
• Mallory–Weiss tears: which are fissures in the lining of the esophagus connecting the throat and stomach, can lead to significant bleeding. These tears are often found in individuals who excessively consume alcohol. 
• Esophageal varices: abnormal and swollen veins within the esophagus, primarily afflict individuals with severe liver disease and can result in substantial bleeding. 
• Esophagitis: an inflammation of the esophagus, is frequently triggered by gastroesophageal reflux disease (GERD). 

Causes of lower GI bleeding  

• Diverticular Disease: This refers to the creation of small, bulging pouches within the digestive tract, known as diverticulosis. If these pouches become inflamed or infected, it is termed diverticulitis. 
• Inflammatory Bowel Disease (IBD): Ulcerative colitis is a form of IBD that triggers inflammation and sores in the colon and rectum. Crohn’s disease, another type of IBD, involves inflammation of the digestive tract lining. 
• Tumors: Benign or cancerous growths in the esophagus, stomach, colon, or rectum can weaken the digestive tract lining, potentially causing bleeding. 
• Colon Polyps: These are clusters of cells that develop on the colon’s lining and can lead to bleeding. While most are harmless, some may be cancerous or have the potential to become cancerous if not removed. 
• Hemorrhoids: Similar to varicose veins, hemorrhoids are swollen veins found in the lower rectum or anus. 
• Anal Fissures: These are small tears occurring in the anus lining.
• Proctitis: Inflammation in the rectal lining can result in rectal bleeding.