Is Gastrointestinal Bleeding Serious
Gastrointestinal (GI) bleeding that occurs due to more serious issues such as bleeding disorders and cancer can be fatal if not treated immediately

Gastrointestinal (GI) bleeding is serious and can be life-threatening depending on the cause.

Most causes of GI bleeding, such as peptic ulcers or hemorrhoids, can be managed fairly easily. However, GI bleeding that occurs due to more serious issues such as bleeding disorders and cancer can be fatal if not treated immediately. 

Identifying the cause of bleeding is crucial even if it is not serious. Hospitalization is often required to understand the severity and source of the bleeding. GI bleeding can occur from one or more locations along the digestive tract, which extends from the mouth to the anus. An accurate diagnosis may prevent further bleeding and help doctors treat future episodes more effectively. 

The overall mortality rate of severe GI bleeding is about 8%, but it is decreasing due to improved diagnostic techniques and newer medical treatments.

What causes gastrointestinal bleeding?

Gastrointestinal (GI) bleeding can be divided into two types depending on the site of bleeding.

Upper GI bleeding

Upper GI bleeding occurs in about 80% of cases and is more common in men, with the risk increasing with age (> 60 years). The upper digestive tract is made of the esophagus, stomach, and upper part of the small intestine.

Common causes of upper GI include:

  • Peptic ulcer (sore in the lining of the stomach or part of the small intestine)
  • Esophageal varices (swollen veins in the esophageal lining)
  • Mallory-Weiss tears (tears in the esophageal lining)
  • Gastritis (inflammation in the stomach lining)
  • Esophagitis (inflammation in the esophageal lining)
  • Benign tumors or noncancerous growths
  • Cancer

Lower GI bleeding

Lower GI bleeding occurs in about 20% of cases. Risk increases with age (a 200-fold increase from the third to ninth decades) and is somewhat more common in men. The lower digestive tract is made up of the lower part of the small intestine, large intestine, rectum, and anus.

Common causes in the lower digestive tract include:

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What are risk factors for gastrointestinal bleeding?

Common risk factors for both upper and lower GI bleeding include:

GI bleeding may also be a sign of more serious diseases and conditions, which may include cancer of the GI tract.

What are symptoms of GI bleeding?

Common symptoms of both upper and lower gastrointestinal bleeding include:

Bleeding can be mild or nearly undetectable or severe and life-threatening. When bleeding is not visible to the naked eye and is only detected through laboratory tests, it is referred to as occult or hidden bleeding.

When should I talk to my doctor about gastrointestinal bleeding?

Any gastrointestinal (GI) bleeding, whether visible or hidden, should be evaluated by a doctor because it could indicate a serious underlying condition. 

Small-volume, bright red, or intermittent bleeding should be evaluated but does not constitute an emergency. Larger-volume, frequent, black, or maroon bleeding or bleeding associated with other symptoms (abdominal pain, nausea, weight loss, etc.) necessitates immediate evaluation. Notify your doctor as soon as possible if you experience GI bleeding.

Depending on your symptoms and their severity, your doctor may recommend the tests below for proper evaluation of your GI bleeding:

Lab tests

  • Complete blood count: To detect anemia from blood loss
  • Fecal occult blood testing: To detect occult bleeding
  • Coagulation factors: Coagulopathy or bleeding disorders
  • Liver function tests: To detect underlying liver disease
  • Other tests: Basic metabolic panel and iron and ferritin values

Imaging

Procedures

How is gastrointestinal bleeding treated?

Emergency care for gastrointestinal bleeding may include:

  • Blood transfusions
  • Intravenous fluids and medications

Once your condition has stabilized, your treatment will be determined by the cause of the bleeding. Common treatment options for GI bleeding may include:

Medications to:

  • Reduce the amount of acid in the stomach 
  • Treat bacterial infections
  • Reduce bleeding
  • Reduce inflammation

Procedures such as:

Surgery may be recommended when other methods fail or to treat conditions such as diverticulitis or uncontrolled bleeding.

To help lower your risk of GI bleeding, your doctor may review your existing medications and recommend lifestyle changes including following a healthy diet, reducing alcohol intake, and quitting smoking.

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Medically Reviewed on 10/14/2022
References
Image Source: iStock image

Symptoms & Causes of GI Bleeding: https://www.niddk.nih.gov/health-information/digestive-diseases/gastrointestinal-bleeding/symptoms-causes

Bleeding in the Digestive Tract: Why It Happens: https://www.webmd.com/digestive-disorders/bleeding-digestive-tract

What is gastrointestinal bleeding? https://www.uclahealth.org/medical-services/radiology/interventional-radiology/conditions-treated/gastrointestinal-bleeding