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Gastrointestinal Bleeding

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Introduction

Gastrointestinal Bleeding (GI bleed) is also known as gastrointestinal haemorrhage or GIB. Gastrointestinal bleeding is any kind of bleeding in the gastrointestinal tract, the region between the mouth and the rectum.

Gastrointestinal Bleeding can lead to shock or anaemia and, in some cases, even cause death if not diagnosed and treated at the right time.

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What is Gastrointestinal Bleeding?

Gastrointestinal Bleeding may be indicative of a severe underlying medical condition in your digestive system. It may also be a symptom of some anomaly in your digestive tract. The blood mostly appears in your vomit or stool and is not always visible to the naked eye.

GI Bleeding causes the stool to appear tarry or even blackish. Gastrointestinal Bleeding can be life-threatening, depending on the amount of blood loss. You should immediately seek medical attention if you vomit blood or see blood in your stool.

To prevent the occurrence of Gastrointestinal Bleeding, you should quit smoking and avoid alcohol consumption. You should also avoid overconsumption of nonsteroidal anti-inflammatory medicines.

What are the Causes of Gastrointestinal Bleeding?

Gastrointestinal Bleeding affects both the upper and the lower gastrointestinal tract. But the causes for both are different and have been discussed below:

  • Upper GI Bleeding causes
  1. A peptic ulcer is the most common cause of upper GI bleeding. Excessive stomach acids produced by bacteria or anti-inflammatory drugs damage the stomach’s lining and the small intestine’s upper portion. The damage leads to the formation of sores which can bleed if not treated on time.
  2. Excessive alcohol consumption can lead to a rupture in the lining of the tube, connecting the throat and the stomach. This condition is known as Mallory-Weiss tears and leads to upper GI Bleeding.
  3. Esophagitis caused by gastroesophageal reflux disease or GERD can cause gastrointestinal bleeding.
  4. Another condition leading to upper GI bleeding is oesophagal varices caused by serious liver problems such as cirrhosis of the liver.
  • Lower GI Bleeding causes
  1. At times, small pouches may develop in the digestive tract, which can become infected or inflamed, leading to diverticular disease. Diverticular disease can lead to lower Gastrointestinal Bleeding.
  2. Ulcerative colitis causes sores and inflammation in the colon, rectum and lining of your digestive tract. These sores can cause bleeding if not diagnosed.
  3. Malignant or benign tumours in the stomach, colon, oesophagus, and rectum can damage the digestive tract’s lining and cause gastrointestinal bleeding.
  4. Small ruptures called anal fissures can lead to bleeding from the lining of the anus.
  5. Haemorrhoids, which are abnormally swollen veins in your anus or lower rectum, can cause lower GI Bleeding.
  6. Colon polyps (a small collection of cells) may damage your colon’s lining and cause bleeding. Colon polyps are mostly harmless, but they can turn cancerous if not removed on time.
  7. Proctitis or damage to the lining of the rectum can also cause lower GI bleeding and inflammation.

What are the Symptoms of Gastrointestinal Bleeding?

The symptoms of Gastrointestinal Bleeding are:

  1. Bloody vomit
  2. Black or tarry stools
  3. Abdominal cramps
  4. Stool with traces of blood
  5. Dizziness
  6. Extreme fatigue
  7. Paleness
  8. Shortness of breath
  9. Vomit which might look like coffee grounds
  10. Weakness and lethargy

Acute Gastrointestinal Bleeding may cause you to go into shock. Such situations require immediate medical attention. The symptoms of shock are:

  1. Blood pressure drops
  2. Pulse rate increases
  3. Urination lessens or stops
  4. Unconsciousness

How is Gastrointestinal Bleeding Diagnosed?

Your doctor will examine you physically and advise the following tests:

  • Stool test: A stool test will confirm if there are traces of blood and the cause of bleeding.
  • Blood tests: your doctor will advise a platelet count, a complete blood count and a liver function test to determine what’s causing your gastrointestinal bleeding and the amount of blood you have lost. A complete blood count will also help decide whether you are suffering from anaemia (from blood loss).
  • Upper endoscopy: Your doctor will examine your upper gastrointestinal by passing a long tube (endoscope) through your mouth with an attached camera.
  • Colonoscopy: The doctor will examine your rectum and large intestine by passing a tube with an attached camera through your rectum.
  • Nasogastric lavage: In this procedure, all the stomach contents are removed by passing a tube through the nose to determine the actual cause of gastrointestinal bleeding.
  • Flexible sigmoidoscopy: The doctor checks the rectum and the end of the large intestine by placing a tube fitted with a camera and light in the rectum.
  • Angiography: An angiography may be conducted to check if there are any bleeding blood vessels.

How is Gastrointestinal Bleeding Treated?

  • ● Doctors can treat the bleeding site during an endoscopy, a flexible sigmoidoscopy, a laparotomy or colonoscopy. They might also inject medicines, use a heat probe, laser or electric current to stop the bleeding or use a clip or band to close the bleeding blood vessels.
  • ● Potent medicines to heal gastrointestinal bleeding may also be prescribed.
  • ● If the bleeding becomes severe and life-threatening, and neither medicines nor other treatment options have worked, surgery might be your last resort. Depending on your condition, either a laparoscopy or a laparotomy may be performed to stop your GI Bleeding.

What is the Results of Gastrointestinal Bleeding Treatment?

In most cases, GI Bleeding heals on its own, but when it doesn’t, treatment is necessary. Upper GI Bleeding is treated by administering IV drugs such as proton pump inhibitors (PPI). These help decrease the production of stomach acids.

Blood loss is controlled through IV fluids and blood transfusions. The prognosis of gastrointestinal bleeding depends on the amount of blood loss and the cause of the bleeding.

What are the Risk Associated with Gastrointestinal Bleeding Treatments?

A surgery through endoscopy is generally safe depending upon the patient’s comorbidities. But complications like sepsis, myocardial infarction or poor wound healing may arise.

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FAQ's

What are the Complications Associated with Gastrointestinal Bleeding?

The complications arising out of a GI Bleed are anaemia, shock, the rapid spread of infection or blood loss.

Is a GI Bleed an Emergency?

GI Bleed becomes an emergency if you vomit blood, have bloody stools or experience symptoms of shock such as unconsciousness.

What is the most Common Cause of Lower Gastrointestinal Bleeding?

Colonic diverticulosis is the most common cause of lower GI Bleeding.

How do I know if I am Bleeding Internally?

If you feel dizzy or experience chest pain, you know you’re Bleeding internally. Other symptoms include bruising on the sides of the abdomen and navel.

Can GI Bleeding be Cured?

GI Bleeding can be cured depending on the cause of the bleeding. Bleeding from haemorrhoids is mostly curable.

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