GI bleeding

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Overview

Gastrointestinal (GI) bleeding is a common problem medical practitioners encounter in the emergency department and in the primary care setting. Annual hospital admissions for GI bleeding in the United States and United Kingdom have been estimated at up to 150 patients per 100000 population with a mortality rate of 5%-10%. While GI bleeding can be potentially life-threatening, it has been shown that many cases can be safely managed on an outpatient basis. The accurate diagnosis of GI bleeding relies on prompt resuscitation, initial risk evaluation, provisional clinical diagnosis followed by appropriate definitive investigation which enables specific interventions. This review provides a practical diagnostic guide for clinicians who may encounter patients with suspected GI bleeding.

Symptoms

black or tarry stool.

bright red blood in vomit.

cramps in the abdomen.

dark or bright red blood mixed with stool.

dizziness or faintness.

feeling tired.

paleness.

shortness of breath.

Causes

Lower GI bleeding can be caused by:


Hemorrhoids. Hemorrhoids are another common cause of GI or rectal bleeding. A hemorrhoid is an enlarged vein in your rectum or anus. These enlarged veins can rupture and bleed, causing rectal bleeding. This condition may resolve on its own or with minimal therapies. However, a doctor may decide to perform a colonoscopy if the bleeding seems suspicious for other more serious GI issues.

Anal fissure. An anal fissure may also cause lower GI bleeding. This is a tear in the muscular ring that forms the anal sphincter. It’s usually caused by constipation or hard stools.

Diverticulosis. This is a chronic condition where the wall of the colon protrudes at the location of vessels and over time can cause the vessels to rupture and bleed. Bleeding due to diverticulosis can often resolve on its own without invasive therapies. A doctor may perform a colonoscopy to rule out other, more serious causes of lower GI bleeding, such as cancer.

Colon cancer. Colon cancer starts in your colon or rectum.

Angiodysplasia. This condition causes enlarged blood vessels in the digestive tract.

Colitis. One of the most common causes of lower GI bleeding is colitis, which occurs when your colon becomes inflamed.

Colitis has several causes, including:


infection

food poisoning

parasites

Crohn’s disease or ulcerative colitis

reduced blood flow in the colon

Risk factors

Chronic vomiting.

Alcoholism.

Medications, including but not limited to. Non-steroidal anti-inflammatories (NSAIDs); commonly used NSAIDs include. Aspirin. Ibuprofen (Advil) Naproxen (Aleve) Anticoagulants.

Gastrointestinal surgery.

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Complications

Bleeding in the digestive tract may be a sign of a serious and life-threatening conditionTrusted Source. It’s important to seek timely medical attention.


Untreated GI bleeding may result in serious complications, including:


respiratory distress

heart attack

infection

shock

death

Prevention

To help prevent a GI bleed:


Limit your use of nonsteroidal anti-inflammatory drugs.

Limit your use of alcohol.

If you smoke, quit.

If you have GERD, follow your doctor's instructions for treating it.