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Gastrointestinal Bleeding

(GI Bleeding; Bleeding, Gastrointestinal; Bleeding, GI)

Definition

Gastrointestinal (GI) bleeding is bleeding in the digestive tract.
The Digestive Tract
si55551180 97870 1 digestive tract
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The digestive tract is divided into 2 sections. The upper digestive tract includes the:
The lower digestive tract includes the:
GI bleeding is a potentially serious symptom that requires care from your doctor.

Causes

GI bleeding is a symptom caused by many possible conditions.
Causes in the upper digestive tract may include:
Causes in the lower digestive tract may include:

Risk Factors

Factors that may increase your chance of GI bleeding include:

Symptoms

Upper digestive tract bleeding symptoms may include:
Lower digestive tract bleeding symptoms may include:
It may be difficult to notice small amounts of blood in the stool. Your doctor can do tests to detect this.
Sometimes, bleeding can occur suddenly and be severe. You may notice symptoms like:
Bleeding that is light and occurs over a long period of time may make you feel tired and short of breath.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include:

Treatment

Treatment will depend on the cause of the bleeding. Your doctor may switch your medications or stop certain ones if it is suspected as the cause of your GI bleeding. You may need to make some lifestyle changes.
Other treatments may include:

Medications

Your doctor may advise medications depending on your symptoms or the results of your tests. Examples include:
  • Proton pump inhibitors (PPIs) or H-2 blockers to reduce stomach acid production
  • Antibiotics to treat Helicobacter pylori or other infections
  • Vasoconstrictors to reduce bleeding
  • Corticosteroids to reduce inflammation
  • Probiotics to introduce healthy bacteria into the GI tract
Some treatments are more effective with a combination of medications.

Endoscopy

Endoscopy can also be used to stop bleeding. With an endoscope, your doctor can stop the bleeding by:
  • Injecting chemicals into the bleeding site
  • Using a heat probe, electric current, or laser to seal off the bleeding site
  • Using a band or clip to close off blood vessels

Angiography

Angiography, which is also used as a diagnostic tool, can control bleeding. The doctor can use angiography with other tools to locate the bleeding and inject medications or other materials into the blood vessels to control it.

Surgery

If other treatment options fail, your doctor may recommend surgery. Surgery may be necessary for some conditions, such as diverticulitis or uncontrolled bleeding.

Prevention

To help reduce your chance of gastrointestinal bleeding:

RESOURCES

American College of Gastroenterology http://www.gi.org

American Gastroenterological Association http://www.gastro.org

CANADIAN RESOURCES

Canadian Association of Gastroenterology http://www.cag-acg.org

Health Canada http://www.hc-sc.gc.ca

References

Acute lower gastrointestinal bleeding. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 21, 2013. Accessed June 20, 2014.

Acute upper nonvariceal gastrointestinal bleeding. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 21, 2013. Accessed June 20, 2014.

Barnert J, Messmann H. Management of lower gastrointestinal tract bleeding. Best Pract Res Clin Gastroenterol. 2008;22(2):295-312.

Bleeding in the digestive tract. National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/bleeding-in-the-digestive-tract/Pages/facts.aspx. Updated March 27, 2012. Accessed June 20, 2014.

Common cancer types. National Cancer Institute website. Available at: http://www.cancer.gov/types/common-cancers. Updated March 21, 2014. Accessed June 20, 2014.

Laine L, Jensen DM. Managment of patients with ulcer bleeding. Am J Gastroenterol. 2012;107(3):345-360.

Laine L, Smith R, Min K, Chen C, Dubois RW. Systematic review: the lower gastrointestinal adverse effects of nonsteroidal anti-inflammatory drugs. Aliment Pharmacol Ther. 2006;24(5):751-767.

Loke YK, Derry S. Risk of gastrointestinal haemorrhage with long-term use of aspirin: Meta-analysis. BMJ. 2000(7270);321:1183-1187.

Wilcox CM, Alexander LN, Cotsonis GA, Clark WS. Nonsteroidal anti-inflammatory drugs are associated with both upper and lower gastrointestinal bleeding. Dig Dis Sci. 1997;42(5):990-997.

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