GI bleeding

To diagnose upper GI bleeding and figure out what’s causing it, a doctor may perform the following tests:

Endoscopy. Upper GI bleeding is most commonly diagnosed with an endoscopy. This procedure involves the use of a small camera located atop a long, flexible endoscopic tube the doctor places down your throat. The scope is then passed through your upper GI tract. The camera allows the doctor to see inside your GI tract and potentially locate the source of your bleeding.

Enteroscopy. This procedure is performed if the cause of your bleeding isn’t found during an endoscopy. An enteroscopy is similar to an endoscopy, except there’s usually a balloon attached to the camera-tipped tube. When inflated, this balloon allows your doctor to open up the intestine and see inside.

Diagnosing lower GI bleeding

A doctor may perform the following tests to determine the cause of lower GI bleeding:

Colonoscopy. During a colonoscopy, your doctor will insert a small, flexible tube into your rectum. A camera is attached to the tube so your doctor can view the entire length of your colon. Air moves through the tube to provide a better view.

Biopsy. During the colonoscopy, the doctor may take a biopsy for additional testing.

X-ray. You may also undergo a scan to locate your GI bleeding. A harmless radioactive tracer will be injected into your veins. The tracer will light up on an X-ray so your doctor can see where you’re bleeding.

CT angiography. A CT scan is an imaging test that can help the doctor locate GI bleeding in the abdomen and pelvis. It often shows more detail than an X-ray.

Capsule endoscopy. If your doctor can’t find the source of your bleeding with an endoscopy or a GI bleeding scan, they may perform a capsule endoscopy. Your doctor will have you swallow a pill that contains a small camera that will take pictures of your bowel to find the source of your bleeding.

RBC nuclear scan. In this exam, a doctor injects a harmless radioactive tracer to track your red blood cells. This can show how the cells perform in your body.

Often, GI bleeding stops on its own. If it doesn't, treatment depends on where the bleed is from. In many cases, medication or a procedure to control the bleeding can be given during some tests. For example, it's sometimes possible to treat a bleeding peptic ulcer during an upper endoscopy or to remove polyps during a colonoscopy.

If you have an upper GI bleed, you might be given an IV drug known as a proton pump inhibitor (PPI) to suppress stomach acid production. Once the source of the bleeding is identified, your doctor will determine whether you need to continue taking a PPI.

Depending on the amount of blood loss and whether you continue to bleed, you might require fluids through a needle (IV) and, possibly, blood transfusions. If you take blood-thinning medications, including aspirin or nonsteroidal anti-inflammatory medications, you might need to stop.