Definition of Gastrointestinal bleeding:

Gastrointestinal (GI) bleeding refers to any bleeding that starts in the gastrointestinal tract.

Bleeding may come from any site along the GI tract, but is often divided into:

• Upper GI bleeding: The upper GI tract includes the esophagus (the tube from the mouth to the stomach), stomach, and first part of the small intestine.
• Lower GI bleeding: The lower GI tract includes much of the small intestine, large intestine or bowels, rectum, and anus.

Considerations:

• Dark, tarry stools
• Larger amounts of blood passed from the rectum
• Small amounts of blood in the toilet bowl, on toilet paper, or in streaks on stool (feces)
• Vomiting blood

Massive bleeding from the GI tract can be dangerous. However, even very small amounts of bleeding that occur over a long period of time can lead to problems such as anemia or low blood counts.

Once a bleeding site is found, many therapies are available to stop the bleeding or treat the cause.

Common Causes:

GI bleeding may be due to conditions that are not serious, including:

• Anal fissure
• Hemorrhoids

However, GI bleeding may also be a sign of more serious diseases and conditions, such as the following cancers of the GI tract:

• Cancer of the colon
• Cancer of the small intestine
• Cancer of the stomach
• Intestinal polyps (a pre-cancerous condition)

Other possible causes of GI bleeding include:

• Abnormal blood vessels in the lining of the intestines (also called angiodysplasias)
• Bleeding diverticulum, or diverticulosis
• Crohn's disease orulcerative colitis
• Esophageal varices
• Esophagitis
• Gastric (stomach) ulcer
• Intussusception (bowel telescoped on itself)
• Mallory-Weiss tear
• Meckel's diverticulum
• Radiation injury to the bowel

Home Care:

There are home stool tests for microscopic blood that may be recommended for people with anemia or for colon cancer screening.

Call your health care provider if:

Call for an appointment with your doctor if:

• You have black, tarry stools (this may be a sign of GI bleeding)
• You have blood in your stool
• You vomit blood or you vomit material that looks like coffee grounds

What to expect at your health care provider's office:

GI bleeding is diagnosed by a doctor -- you may or may not be aware of its presence.

GI bleeding can be an emergency condition requiring immediate medical attention. Treatment may involve:

• Blood transfusions
• Fluids and medicines through a vein
• Esophagogastroduodenoscopy (EGD) - a thin tube with a camera on the end is passed through your mouth into your esophagus, stomach, and small intestine
• A tube is placed through your mouth into the stomach to drain the stomach contents (gastric lavage)

Once your condition is stable, you will have a physical examination, including a detailed abdominal examination.

You will also be asked questions about your symptoms, including:

• When did you first notice symptoms?
• Did you have black, tarry stools or red blood in the stools?
• Have you vomited blood?
• Did you vomit material that looks like coffee grounds?
• Do you have a history of peptic or duodenal ulcers?
• Have you ever had symptoms like this before?
• What other symptoms do you have?

Tests that may be done to find the source of the bleeding include:

• Abdominal CT scan
• Abdominal MRI scan
• Abdominal x-ray
• Angiography
• Bleeding scan (tagged red blood cell scan)
• Blood clotting tests
• Capsule endoscopy (camera pill that is swallowed to look at the small intestine)
• Colonoscopy
• Complete blood count (CBC), clotting tests, platelet count, and other laboratory tests
• Enteroscopy
• Sigmoidoscopy