Gastrointestinal (GI) hemorrhages are classified either as upper GI bleeds or lower GI bleeding, depending on where along the intestinal tract the blood originates. Different conditions can result in bleeding that might come from the mouth or the anus. Ulcers, tears in the esophagus, hemorrhoids, and gastritis are the most common causes of GI hemorrhages. Although some GI bleeding stops by itself, the problem could worsen and become life threatening without treatment.
Upper GI hemorrhages occur between the mouth and the stomach. Ulcers are the most common cause of this type of bleeding, and they can appear either in the intestine or stomach. Excess stomach acid might eat a hole in the artery wall and cause GI hemorrhages. Alcohol, smoking, or bacteria in the gut can lead to the formation of ulcers. Stress might contribute to the condition.
A tear in the lining of the esophagus from projectile vomiting is another cause of upper GI bleeding. Physicians routinely use an endoscope to find the source of blood. Rips in the esophageal lining can usually be controlled with laser cauterization or injections of medication to stem blood loss. Sometimes, clips or banding are used to close off the bleeding vein.
Gastrointestinal hemorrhages commonly occur in people who use aspirin for other medical conditions. Over time, the medication can inflame the lining of the stomach and produce gastritis. Medication is usually used to heal the inflammation and ulcers that may have formed in the stomach.
Lower GI hemorrhages stem from bleeding between the stomach and anus. A bloody or dark stool is usually the first sign of lower GI bleeding. Hemorrhoids, which are engorged veins near the anus, can produce bright red blood. Black or dark stools might signal diverticulitis, pouches that form on the colon, or colon cancer. Doctors routinely perform colonoscopy through the anal opening to diagnose the cause of lower GI hemorrhages.
Signs of internal bleeding include vomiting blood or a substance that looks like coffee grounds. Rectal bleeding or dark stools indicate a potential lower GI hemorrhage. Other symptoms include fatigue from blood loss, or a pale appearance caused by anemia. If an ulcer is causing the condition, stomach pain may be present. Those with colon cancer sometimes see an unexpected weight loss.
In severe cases of GI hemorrhages, a blood transfusion may be necessary to replace lost blood. Controlling blood loss is deemed critical by emergency room doctors if a large vessel has ruptured. Surgery is sometimes necessary to stop bleeding when other methods fail, or for esophageal, stomach, or colon cancer.
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