Gastrointestinal bleeding and its causes

Gastrointestinal (GI) bleeding is a serious medical condition that involves bleeding from any part of the gastrointestinal tract, which extends from the mouth to the anus. This condition can range from mild to severe and can be indicative of various underlying health issues.

Understanding the causes, symptoms, and treatment options is crucial for managing GI bleeding effectively. Here to provide a detailed insight into this is leading consultant gastroenterologist and hepatologist Dr Marek Czajkowski.    

What is gastrointestinal bleeding?

It is any form of bleeding that takes place within the digestive tract. The bleeding can be classified based on its location: upper GI bleeding or lower GI bleeding.

• Upper GI bleeding: This occurs in the upper parts of the digestive system, such as the oesophagus, stomach and the first part of the small intestine (duodenum).
• Lower GI bleeding: This occurs in the lower parts of the digestive system, including the small intestine beyond the duodenum, large intestine (colon), rectum and anus.

What are the common causes of gastrointestinal bleeding?

The causes of GI bleeding can vary depending on whether the bleeding originates from the upper or lower gastrointestinal tract.

Upper GI bleeding

• Peptic ulcers: Open sores that develop on the inner lining of the stomach and upper portion of the small intestine.
• Gastritis: Inflammation of the stomach lining.
• Oesophageal varices: Enlarged veins in the lower oesophagus, often due to liver cirrhosis.
• Mallory-Weiss tear: A tear in the mucous membrane at the junction of the oesophagus and stomach, often caused by severe vomiting.
• Oesophagitis: Inflammation of the oesophagus, which can be caused by acid reflux.

Lower GI bleeding

• Diverticulitis: Small, bulging pouches (diverticula) that can form in the digestive system and may bleed.
• Inflammatory bowel disease (IBD): Conditions such as Crohn's disease and ulcerative colitis that cause inflammation of the GI tract.
• Colorectal polyps: Growths on the inner lining of the colon or rectum that can bleed.
• Colorectal cancer: A malignant tumour of the colon or rectum.
• Haemorrhoids: Swollen veins in the lowest part of the rectum and anus.

What are the symptoms of gastrointestinal bleeding?

Symptoms of GI bleeding can vary depending on the source and severity of the bleeding. Common signs and symptoms include:

• Haematemesis: Vomiting blood, which may appear bright red or resemble coffee grounds.
• Melena: Black, tarry stools indicating digested blood from upper GI bleeding.
• Haematochezia: Bright red blood in stools, often from lower GI bleeding.
• Anaemia: Symptoms such as fatigue, weakness, and shortness of breath due to blood loss.
• Abdominal pain: Discomfort or pain in the abdomen, which may be associated with the underlying cause of the bleeding.

How is gastrointestinal bleeding diagnosed?

Diagnosing GI bleeding involves several steps, including:

• Medical history and physical examination: The doctor will take a detailed medical history and perform a physical exam to identify potential sources of bleeding.
• Blood tests: These tests can help assess the extent of blood loss and the patient's overall health.
• Endoscopy: Upper GI endoscopy (oesophagogastroduodenoscopy) or lower GI endoscopy (colonoscopy) can be used to directly visualise the inside of the GI tract and identify the source of bleeding.
• Imaging studies: CT scans, MRI or angiography may be used to detect bleeding that is not visible through endoscopy.

What are the treatment options for gastrointestinal bleeding?

The treatment of GI bleeding depends on the severity and underlying cause of the bleeding. Treatment options include:

• Medications: Proton pump inhibitors, antibiotics or drugs to reduce portal hypertension may be prescribed.
• Endoscopic therapy: Procedures such as endoscopic banding, clipping or injection can be used to stop bleeding during an endoscopy.
• Surgery: In severe cases, surgical intervention may be necessary to remove the source of bleeding or repair damaged tissues.
• Blood transfusions: In cases of significant blood loss, blood transfusions may be required to stabilise the patient.

Do you require expert treatment regarding gastrointestinal bleeding? Arrange a consultation via Dr Czaikowski’s Top Doctors profile.