Gastrointestinal (GI) bleeding is bleeding in the digestive tract, anywhere from the throat to the rectum. A person can experience a small loss of blood, such as when a hemorrhoid bleeds, or a hemorrhage, which causes a substantial blood loss.
In this article, we discuss GI bleeding, its symptoms, severity, potential causes, risk factors, and complications. We also explain when a person should seek guidance from a doctor.
The bleeding may appear suddenly and produce a lot of blood, or a person may notice gradual or periodic bleeding.
Sudden, heavy bleeding is more immediately dangerous. However, both types of bleeding may signal a serious medical condition.
Doctors usually distinguish between upper and lower GI bleeding.
Upper GI bleeding is when a person bleeds from the upper digestive tract, that is, anywhere above the ligament of Treitz, which is the first part of the small intestine.
Lower GI bleeding happens in the lower portion of the digestive tract, including the intestines and rectum.
People with upper GI bleeding may have the following symptoms:
- bleeding from the throat
- blood in sputum
- blood in vomit
- dark or bright red blood in stool
- very dark, foul-smelling stool
If people notice that a baby’s stool is suddenly black or tarry, they should contact a doctor immediately, as this may mean there is an upper GI bleed.
Symptoms of a lower GI bleed can include:
- blood on toilet paper or baby wipes after wiping
- bleeding from the anus
- red blood in stool
A serious, significant bleed, especially in the upper GI tract, may cause other symptoms, such as:
- little or no urine to pass
- a drop in blood pressure
- intense nausea
- loss of consciousness
- fast heart rate
Children may show changes in behavior, become very lethargic, cry more than usual, or struggle to stay alert and awake.
GI bleeding is not always a cause for concern. For example, a bleeding hemorrhoid may resolve on its own or with home treatment, such as a warm bath or over-the-counter cream.
Also, bleeding from the throat could happen if a person swallows food or a substance that damages the tissue lining the throat. However, it may also signal an underlying condition.
It is important to consult a doctor about any GI bleeding rather than self-diagnose the cause.
Some types of GI bleeding are life threatening and require prompt treatment. Typically, upper GI bleeds are
Sudden bleeding may produce symptoms of shock, such as blood pressure changes or a rapid pulse. People with symptoms of an upper GI bleed or shock need emergency medical treatment.
A number of conditions can lead to GI bleeds.
Upper GI bleeds
Potential causes of bleeding in the upper GI tract include:
Bleeding peptic ulcers
A person with peptic ulcers may experience a burning sensation in the stomach. To help treat these, doctors may prescribe medication.
Varices are enlarged blood vessels in the upper GI tract, usually in the esophagus, or food pipe. They can be a result of cirrhosis, which is a serious liver condition.
A doctor may stop bleeding from varices with the use of elastic bands.
Growths in the digestive tract, including both benign and cancerous tumors, may cause bleeding.
Some people also notice other symptoms, such as difficulty swallowing, but not all growths cause symptoms.
A person may require surgery to remove the growth.
People with esophagitis may have frequent bouts of heartburn. Treatment may include medication to reduce stomach acid levels.
Injury or tear
Both tears and injuries in the GI tract can be a result of trauma or excessive vomiting.
They may heal on their own, or a person may need insertion of a band or clip to repair them.
Recent surgery may increase the risk of infection, or damage the digestive tract. Doctors may use injections or heat probes to help stop any bleeding.
Some types of upper GI bleeds can cause serious bleeding that may be life threatening. A ruptured vein in the esophagus, for example, can cause a hemorrhage.
Lower GI bleeds
Potential causes of bleeding in the lower GI tract include:
Dietary changes and antibiotics may help treat diverticulitis. Treatment may also include bowel rest, which is when a person does not consume any food or drink by mouth until their condition improves.
A hemorrhoid is a swollen blood vessel in the rectum. It may bleed when a person wipes the anus. Sometimes, it also appears after constipation.
Straining from constipation may lead to hemorrhoids, which can cause minor bleeding from the rectum.
Colon polyps are growths of tissue inside the colon and rectum. In some cases, they can become cancerous over time.
Removal of colon polyps can prevent them from turning into colon cancer.
Colitis can cause ulcers in the large intestine. This in turn may lead to bleeding and sometimes pain.
Medications may help reduce inflammation in the large intestine.
Inflammatory bowel disease
People with inflammatory bowel disease (IBD) may experience a range of intestinal symptoms, including frequent diarrhea or constipation.
Medication and dietary changes may help manage IBD.
Anal fissures and other anal injuries
Tears or damage to the anus may cause bleeding or pain. The pain may appear suddenly or worsen gradually over time.
Doctors may recommend fiber supplements and warm baths to help treat fissures.
There are no specific symptoms that distinguish cancer from other conditions. In some people, the first symptom is bleeding.
A person may require surgery to remove cancerous growths or a portion of the colon.
Recent medical procedures
If a person has constant bleeding, they should medical attention.
Digestive tract infections
Such infections may clear on their own. Sometimes, however, people may need antibiotics.
Anyone can have a GI bleed, especially if they experience other digestive issues, such as colitis or peptic ulcers.
Risk factors for GI bleeding include:
- using anticoagulants, which are a group of drugs that can thin the blood and may therefore increase bleeding
- using too much NSAIDs
- vomiting excessively, also from eating disorders
- having alcohol use disorder
- having recently undergone surgery or traumatic injury
- older age
- substantial blood loss
- abnormal vital signs
- constant bleeding
Moreover, people with GERD may need to avoid certain foods, such as foods that are acidic, spicy, or fatty.
A person with serious GI bleeding usually needs treatment in hospital so that a doctor can monitor their condition.
They may require extra fluids, supplemental oxygen, or medication for any underlying conditions.
Some potential complications of a GI bleed are:
- cancer that progresses without treatment
- serious blood loss that may be life threatening
- heart attack and other heart health symptoms
People need to consult a doctor if they notice any symptoms of GI bleeding.
A person should call 911 or go to the emergency room if:
- they have other symptoms, such as a rapid heart rate, fever, or confusion
- they experience other signs of an upper GI bleed, such as vomit with blood in it, or dark, tarry stools
- they have lost a significant amount of blood, for example, by constantly bleeding from the rectum or mouth
- a newborn shows signs of a GI bleed
GI bleeding can be due to a number of causes, and treatment will depend on what the bleeding results from.
In some cases, doctors may recommend ongoing management of the condition to relieve symptoms.
A person needs to contact a doctor if they experience any symptoms of GI bleeding. Doing so without delay can help prevent complications.
If a person has severe symptoms or bleeding, they should seek medical attention immediately.