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{{Gastrointestinal bleeding (patient information)}}
'''For the WikiDoc page for this topic, click [[Gastrointestinal bleeding|here]]'''
'''For the WikiDoc page for this topic, click [[Gastrointestinal bleeding|here]]'''
{{SI}}


'''Editor-in-Chief:''' Meagan E. Doherty
{{CMG}}; {{AE}} {{KD}} '''Assistant Editor-in-Chief:''' Meagan E. Doherty
==Overview==
Gastrointestinal (GI) bleeding refers to any bleeding that starts in the [[gastrointestinal tract]].


{{EJ}}
[[Bleeding]] may come from any site along the GI tract, but is often divided into:


==What is Gastrointestinal bleeding?==
* Upper GI bleeding: The upper GI tract includes the [[esophagus]] (the tube from the mouth to the stomach), [[stomach]], and first part of the [[small intestine]].
Gastrointestinal (GI) bleeding refers to any bleeding that starts in the [[gastrointestinal tract]], which extends from the [[mouth]] to the [[anus]].
* Lower GI bleeding: The lower GI tract includes much of the [[small intestine]], [[large intestine]] or bowels, [[rectum]], and [[anus]].


The amount of bleeding can range from nearly undetectable to acute, massive, and life threatening.
==What are the symptoms of Gastrointestinal bleeding?==
The amount of GI bleeding may be so small that it can only be detected on a lab test such as the [[fecal occult blood test]]. Other signs of GI bleeding include:


Bleeding may come from any site along the GI tract, but is often divided into:
* Dark, tarry stools
* Upper GI bleeding: The upper GI tract is located between the mouth and the upper part of the small intestine.
* Larger amounts of blood passed from the rectum
* Lower GI bleeding: The lower GI tract is located between the upper part of the small intestine and the anus. The lower GI tract includes the small and large bowels.
* Small amounts of blood in the toilet bowl, on toilet paper, or in streaks on stool (feces)
* Vomiting blood


==What are the symptoms of Gastrointestinal bleeding?==
Massive bleeding from the GI tract can be dangerous. However, even very small amounts of bleeding that occur over a long period of time can lead to problems such as anemia or low blood counts.
The signs of bleeding in the digestive tract depend upon the site and severity of bleeding. If blood is coming from the [[rectum]] or the lower [[colon]], bright red blood will coat or mix with the stool. The stool may be mixed with darker blood if the bleeding is higher up in the colon or at the far end of the [[small intestine]]. When there is bleeding in the [[esophagus]], [[stomach]], or [[duodenum]], the stool is usually black or tarry. Vomited material may be bright red or have a coffee-grounds appearance when one is bleeding from those sites. If bleeding is occult, the patient might not notice any changes in stool color.


If sudden massive bleeding occurs, a person may feel weak, [[dizzy]], faint, short of breath, or have crampy [[abdominal pain]] or [[diarrhea]]. Shock may occur, with a rapid pulse, drop in blood pressure, and difficulty in producing urine. The patient may become very pale. If bleeding is slow and occurs over a long period of time, a gradual onset of fatigue, lethargy, shortness of breath, and pallor from the [[anemia]] will result. [[Anemia]] is a condition in which the blood's iron-rich substance, [[hemoglobin]], is diminished.
Once a bleeding site is found, many therapies are available to stop the bleeding or treat the cause.
==What causes Gastrointestinal bleeding?==
GI bleeding may be due to conditions that are not serious, including:


==What are the causes of Gastrointestinal bleeding?==
* [[Anal fissure]]
* [[Hemorrhoids]]


==Who is at risk for Gastrointestinal bleeding?==
However, GI bleeding may also be a sign of more serious diseases and conditions, such as the following cancers of the GI tract:


==How to know you have Gastrointestinal bleeding?==
* [[Cancer of the colon]]
he site of the bleeding must be located. A complete history and physical examination are essential. Symptoms such as changes in bowel habits, stool color (to black or red) and consistency, and the presence of pain or tenderness may tell the doctor which area of the GI tract is affected. Because the intake of iron, bismuth (Pepto Bismol), or foods such as beets can give the stool the same appearance as bleeding from the digestive tract, a doctor must test the stool for blood before offering a diagnosis. A blood count will indicate whether the patient is anemic and also will give an idea of the extent of the bleeding and how chronic it may be.
* Cancer of the small intestine
* [[Cancer of the stomach]]
* Intestinal polyps (a pre-cancerous condition)


===Endoscopy===
Other possible causes of GI bleeding include:
[[Endoscopy]] is a common diagnostic technique that allows direct viewing of the bleeding site. Because the endoscope can detect lesions and confirm the presence or absence of bleeding, doctors often choose this method to diagnose patients with acute bleeding. In many cases, the doctor can use the endoscope to treat the cause of bleeding as well.


The [[endoscope]] is a flexible instrument that can be inserted through the mouth or [[rectum]]. The instrument allows the doctor to see into the [[esophagus]], [[stomach]], [[[duodenum]] ([[esophago-duodenoscopy]]), [[colon]] ([[colonoscopy]]), and [[rectum]] ([[sigmoidoscopy]]); to collect small samples of tissue ([[biopsies]]); to take photographs; and to stop the bleeding.
* Abnormal blood vessels in the lining of the intestines (also called [[angiodysplasia]]s)
* Bleeding [[diverticulum]], or [[diverticulosis]]
* [[Crohn's disease]] or [[ulcerative colitis]]
* [[Esophageal varices]]
* [[Esophagitis]]
* Gastric (stomach) ulcer
* [[Intussusception]] (bowel telescoped on itself)
* [[Mallory-Weiss tear]]
* [[Meckel's diverticulum]]
* [[Radiation injury]] to the bowel


Small bowel endoscopy, or [[enteroscopy]], is a procedure using a long endoscope. This endoscope may be used to localize unidentified sources of bleeding in the small intestine.
==Who is at highest risk?==
Call for an appointment with your doctor if:


A new diagnostic instrument called a capsule endoscope is swallowed by the patient. The capsule contains a tiny camera that transmits images to a video monitor. It is used most often to find bleeding in portions of the small intestine that are hard to reach with a conventional endoscope.
* You have black, tarry stools (this may be a sign of GI bleeding)
* You have blood in your [[stool]]
* You vomit blood or you vomit material that looks like coffee grounds


===Other Procedures===
==Diagnosis==
Several other methods are available to locate the source of bleeding. [[Barium x rays]], in general, are less accurate than endoscopy in locating bleeding sites. Some drawbacks of barium x rays are that they may interfere with other diagnostic techniques if used for detecting acute bleeding, they expose the patient to x rays, and they do not offer the capabilities of biopsy or treatment. Another type of x ray is CT scan, particularly useful for inflammatory conditions and cancer.
GI bleeding is diagnosed by a doctor -- you may or may not be aware of its presence.


[[Angiography]] is a technique that uses dye to highlight blood vessels. This procedure is most useful in situations when the patient is acutely bleeding such that dye leaks out of the blood vessel and identifies the site of bleeding. In selected situations, angiography allows injection of medicine into arteries that may stop the bleeding.
There are home stool tests for microscopic blood that may be recommended for people with anemia or for [[colon cancer]] screening.


[[Radionuclide scanning]] is a noninvasive screening technique used for locating sites of acute bleeding, especially in the lower GI tract. This technique involves injection of small amounts of radioactive material. Then, a special camera produces pictures of organs, allowing the doctor to detect a bleeding site.
You will also be asked questions about your symptoms, including:


==When to seek urgent medical care==
* When did you first notice symptoms?
* Did you have black, tarry stools or red blood in the [[stool]]s?
* Have you vomited blood?
* Did you vomit material that looks like coffee grounds?
* Do you have a history of peptic or [[duodenal ulcer]]s?
* Have you ever had symptoms like this before?
* What other symptoms do you have?
 
Tests that may be done to find the source of the bleeding include:
 
* Abdominal CT scan
* Abdominal MRI scan
* [[Abdominal x-ray]]
* [[Angiography]]
* Bleeding scan (tagged red blood cell scan)
* Blood clotting tests
* [[Capsule endoscopy]] (camera pill that is swallowed to look at the small intestine)
* [[Colonoscopy]]
* [[Complete blood count]] (CBC), clotting tests, platelet count, and other laboratory tests
* [[Enteroscopy]]
* [[Sigmoidoscopy]]
 
==When to seek urgent medical care?==
Call for an appointment with your doctor if:
Call for an appointment with your doctor if:
* You have black, tarry stools (this may be a sign of upper GI bleeding)
 
* You have blood in your stool  
* You have black, tarry stools (this may be a sign of GI bleeding)
* You have blood in your stool
* You vomit blood or you vomit material that looks like coffee grounds
* You vomit blood or you vomit material that looks like coffee grounds


==Treatment options==
==Treatment options==
GI bleeding can be an emergency condition requiring immediate medical attention. Treatment may involve:
* [[Blood transfusion]]s
* [[Fluid]]s and [[medicine]]s through a [[vein]]
* [[Esophagogastroduodenoscopy]] (EGD) - a thin tube with a camera on the end is passed through your mouth into your [[esophagus]], [[stomach]], and [[small intestine]]
* A tube is placed through your mouth into the stomach to drain the stomach contents (gastric lavage)


==Diseases with similar symptoms==
Once your condition is stable, you will have a physical examination, including a detailed abdominal examination.


==Where to find medical care for Gastrointestinal bleeding==
===Medications to avoid===
[http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|yourdisease}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating Gastrointestinal bleeding]
{{MedCondContrPI


==Prevention of Gastrointestinal bleeding==
|MedCond =Gastrointestinal bleeding|Abciximab|Metoclopramide}}


==What to expect (Outlook/Prognosis)==
==Where to find medical care for Gastrointestinal bleeding?==
[http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Condition}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wl Directions to Hospitals Treating Gastrointestinal bleeding]


==Sources==
==Sources==
*http://www.nlm.nih.gov/medlineplus/gastrointestinalbleeding.html
*http://www.nlm.nih.gov/medlineplus/ency/article/003133.htm
*http://digestive.niddk.nih.gov/ddiseases/pubs/bleeding/#recognized


[[Category:Patient information]]
[[Category:Surgery]]
[[Category:Gastroenterology]]
[[Category:Conditions diagnosed by stool test]]
[[Category:Emergency medicine]]




{{SIB}}
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{{WH}}
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{{WS}}
[[Category:Patient Information]]

Latest revision as of 20:11, 5 June 2015

Gastrointestinal bleeding

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Gastrointestinal bleeding ?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

Gastrointestinal bleeding On the Web

Ongoing Trials at Clinical Trials.gov

Images of Gastrointestinal bleeding

Videos on Gastrointestinal bleeding

FDA on Gastrointestinal bleeding

CDC on Gastrointestinal bleeding

Gastrointestinal bleeding in the news

Blogs on Gastrointestinal bleeding

Directions to Hospitals Treating Gastrointestinal bleeding

Risk calculators and risk factors for Gastrointestinal bleeding

For the WikiDoc page for this topic, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2] Assistant Editor-in-Chief: Meagan E. Doherty

Overview

Gastrointestinal (GI) bleeding refers to any bleeding that starts in the gastrointestinal tract.

Bleeding may come from any site along the GI tract, but is often divided into:

What are the symptoms of Gastrointestinal bleeding?

The amount of GI bleeding may be so small that it can only be detected on a lab test such as the fecal occult blood test. Other signs of GI bleeding include:

  • Dark, tarry stools
  • Larger amounts of blood passed from the rectum
  • Small amounts of blood in the toilet bowl, on toilet paper, or in streaks on stool (feces)
  • Vomiting blood

Massive bleeding from the GI tract can be dangerous. However, even very small amounts of bleeding that occur over a long period of time can lead to problems such as anemia or low blood counts.

Once a bleeding site is found, many therapies are available to stop the bleeding or treat the cause.

What causes Gastrointestinal bleeding?

GI bleeding may be due to conditions that are not serious, including:

However, GI bleeding may also be a sign of more serious diseases and conditions, such as the following cancers of the GI tract:

Other possible causes of GI bleeding include:

Who is at highest risk?

Call for an appointment with your doctor if:

  • You have black, tarry stools (this may be a sign of GI bleeding)
  • You have blood in your stool
  • You vomit blood or you vomit material that looks like coffee grounds

Diagnosis

GI bleeding is diagnosed by a doctor -- you may or may not be aware of its presence.

There are home stool tests for microscopic blood that may be recommended for people with anemia or for colon cancer screening.

You will also be asked questions about your symptoms, including:

  • When did you first notice symptoms?
  • Did you have black, tarry stools or red blood in the stools?
  • Have you vomited blood?
  • Did you vomit material that looks like coffee grounds?
  • Do you have a history of peptic or duodenal ulcers?
  • Have you ever had symptoms like this before?
  • What other symptoms do you have?

Tests that may be done to find the source of the bleeding include:

When to seek urgent medical care?

Call for an appointment with your doctor if:

  • You have black, tarry stools (this may be a sign of GI bleeding)
  • You have blood in your stool
  • You vomit blood or you vomit material that looks like coffee grounds

Treatment options

GI bleeding can be an emergency condition requiring immediate medical attention. Treatment may involve:

Once your condition is stable, you will have a physical examination, including a detailed abdominal examination.

Medications to avoid

Patients diagnosed with Gastrointestinal bleeding should avoid using the following medications:

  • Abciximab
  • Metoclopramide
    If you have been diagnosed with Gastrointestinal bleeding, consult your physician before starting or stopping any of these medications.


Where to find medical care for Gastrointestinal bleeding?

Directions to Hospitals Treating Gastrointestinal bleeding

Sources


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