GI Bleeding

Gastrointestinal (GI) bleeding refers to blood loss from any part of the digestive tract, ranging from the mouth to the rectum. It can be acute (sudden and severe) or chronic (gradual and mild), and its severity depends on the underlying cause, location, and volume of blood loss.

Symptoms

Symptoms of GI bleeding vary depending on its location and intensity. Common signs include:

Upper GI bleeding symptoms:

• Hematemesis: Vomiting blood (red or coffee-ground appearance).
• Melena: Black, tarry stools indicating digested blood.
• Abdominal pain or discomfort.
• Fatigue and dizziness in severe cases due to anemia.

Lower GI bleeding symptoms:

• Hematochezia: Bright red blood in stools.
• Abdominal cramping or discomfort.
• Weakness or lightheadedness from significant blood loss.

Causes

GI bleeding can be categorized based on its origin:

Upper GI bleeding causes:

• Peptic ulcers (most common): Erosion of stomach or duodenal lining due to Helicobacter pylori infection or NSAID use.
• Esophageal varices: Swollen veins in the esophagus, often due to liver disease.
• Gastritis: Inflammation of the stomach lining.
• Mallory-Weiss tears: Tears in the esophageal lining caused by severe vomiting.
• Esophagitis: Often associated with acid reflux.

Lower GI bleeding causes:

• Diverticulosis: Pouches in the colon that can bleed.
• Inflammatory bowel diseases (Crohn’s disease, ulcerative colitis).
• Hemorrhoids: Swollen veins in the rectum or anus.
• Colorectal cancer or polyps.
• Angiodysplasia: Fragile blood vessels in the colon.

Treatment

Treatment focuses on stopping the bleeding, addressing the underlying cause, and preventing recurrence.

Initial management:

• Hospitalization and intravenous fluids for stabilization in severe cases.
• Blood transfusion for significant anemia or ongoing blood loss.

Diagnosis:

• Endoscopy: For direct visualization and treatment of upper GI bleeding.
• Colonoscopy: To identify and manage lower GI bleeding.
• Imaging studies or capsule endoscopy for obscure bleeding sources.

Specific interventions:

• Medications: Proton pump inhibitors (PPIs) for ulcers or acid-related causes, antibiotics for infections, or drugs to reduce variceal pressure.
• Endoscopic procedures: Cauterization, clipping, or banding of bleeding vessels.
• Surgery: Reserved for cases unresponsive to other treatments.