Common Causes Of Gastrointestinal Bleeding
What Are The Possible Complications
An untreated ulcer that swells or scars can block your digestive tract. It can also perforate your stomach or small intestine, infecting your abdominal cavity. That causes a condition known as peritonitis.
A bleeding ulcer can lead to anemia, bloody vomit, or bloody stools. A bleeding ulcer usually results in a hospital stay. Severe internal bleeding is life-threatening. Perforation or serious bleeding may require surgical intervention.
What Is Internal Bleeding
While most people understand that internal bleeding refers to bleeding that can’t be seen on the outside of the body, medical personnel tend to use terms that describe more precisely the location inside the body where the bleeding is found. The internal bleeding may occur within tissues, organs, or in cavities of the body including the head, spinal canal, chest, and abdomen. Examples of other potential sites of bleeding include the eye and within tissues that line the heart, muscles, and joints.
- External bleeding is quite easy to recognize. If the skin is damaged by a laceration, puncture wound, or abrasion, blood can be witnessed as it streams out of the body. The scalp and face have a very rich blood supply and are notorious for demonstrating massive blood loss.
- Internal bleeding may be much more difficult to identify. It may not be evident for many hours after it begins, and symptoms may only occur when there is significant blood loss or if a blood clot is large enough to compress an organ and prevent it from functioning properly.
People who take blood-thinning or anti-clotting medication are more prone to bleeding than people who do not take these medications. These individuals may experience significant bleeding even with relatively minor injury or illness, and the risk of bleeding needs to be balanced against the benefits of taking the medication. A variety of “blood thinning” medications are now prescribed for many diseases.
Anticoagulation medications include:
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How Do Gi Bleeds Occur
There are many causes for a GI bleed, depending on where it is. The most common causes of an upper GI bleed include:
- Peptic ulcers, usually caused by H.pylori infection
- Tears in the esophagus, often caused by excessive use of alcohol
- Esophageal varices, enlarged veins in the esophagus, often the result of serious liver disease
- Esophagitis, inflammation of the esophagus, often caused by gastroesophageal reflux disease
You could also develop a perforation in your upper GI tract if you take certain types of medications, such as ASA and nonsteroidal anti-inflammatory drugs, NSAIDS, including ibuprofen. Other drugs can increase your risk of bleeding overall, such as anticoagulants .
Internal Bleeding In Your Head
This can cause:
- overall weakness
The presence of other underlying conditions may help doctors identify if youre losing blood somewhere.
For example,anemia is commonly associated with a slow and chronic internal bleeding. It can cause fatigue, weakness, and shortness of breath.
Some people with internal bleeding will also have low blood pressure because of the constant blood loss. This is known as orthostatic hypotension. Common symptoms include feeling dizzy or light-headed when you stand.
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What Are The Symptoms Of A Peptic Ulcer
Youâll most likely feel a burning pain or discomfort between your belly button and breastbone. You might especially notice it on an empty stomach such as between meals or at night. The pain may stop for a little while if you eat or take an antacid, but then return. The pain can last for a few minutes or a few hours, and may come and go for many days or weeks.
Other symptoms may include:
Small ulcers may not cause any symptoms. But if you notice any of these signs, talk to your doctor.
What Can I Expect
Most children with an upper GI bleed recover very well. Those with certain liver or clotting problems can suffer from more serious and repeated bleeds. Blood transfusions or surgery might be indicated in the more severe cases. Management in the hospital by pediatric specialists will help provide optimal care.
In lower GI bleeding, polyps in children are mostly benign and usually do not recur. Follow up colonoscopy might be necessary in some cases.
Preventing constipation will help avoid the recurrence of fissures and rectal irritation.
If colitis is the reason for the bleeding, medications will be prescribed to heal the inflammation.
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What You Can Do
When you make the appointment, ask if there’s anything you need to do in advance, such as fasting before a specific test. Make a list of:
- Your symptoms, including any that seem unrelated to the reason for your appointment and when they began
- All medications, vitamins or other supplements you take, including doses
- History of digestive disease you’ve been diagnosed with, such as GERD, peptic ulcers or IBD
- Questions to ask your doctor
Take a family member or friend along, if possible, to help you remember the information you’re given.
For gastrointestinal bleeding, basic questions to ask your doctor include:
- I’m not seeing blood, so why do you suspect a GI bleed?
- What’s likely causing my symptoms?
- Other than the most likely cause, what are other possible causes for my symptoms?
- What tests do I need?
- Is my condition likely temporary or chronic?
- What’s the best course of action?
- What are the alternatives to the primary approach you’re suggesting?
- I have other health conditions. How can I best manage them while my bleeding is treated?
- Are there restrictions I need to follow?
- Should I see a specialist?
- Are there brochures or other printed material I can have? What websites do you recommend?
Don’t hesitate to ask other questions.
What Is A Gastrointestinal Bleed
A GI bleed isnt a condition or disease, but the symptom of one. You can have an acute bleed one that occurs quickly and suddenly, or a chronic bleed. A chronic GI bleed may come and go and usually isnt severe. It still should be investigated though, because your doctor needs to know why its occurring and if left for too long, a chronic bleed can cause other complications like anemia.
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What Triggers Stomach Ulcer Symptoms
Stomach ulcer symptoms are irritated by several triggers. They include:
- Stomach acid â some people notice it after they eat while others notice it more on an empty stomach
Our site is the source of information about the gastroenterology related conditions and procedures. This information is intended for patients looking to learn about our gastroenterology practice in New York and make an appointment to see one of our physicians. This information is only intended to provide guidance, not definitive medical advice. Please consult a doctor or GI specialist about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment. Terms and conditions are subject to change.
Will I Need A Procedure
In many cases, healthcare providers deliver GI bleed treatments during an endoscopy or colonoscopy. Tiny instruments at the tip of the endoscope or colonoscope make it possible to:
- Remove abnormal growths, such as colon polyps.
- Inject medications that help the body stop bleeding.
- Seal abnormal blood vessels with a tiny clip or band.
- Use low levels of a laser or a hot or cold gas to destroy the tissue causing the bleed.
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What To Expect At Your Office Visit
Your provider may discover GI bleeding during an exam at your office visit.
GI bleeding can be an emergency condition that requires immediate medical care. Treatment may involve:
- Blood transfusions.
- Fluids and medicines through a vein.
- Esophagogastroduodenoscopy . 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 .
Once your condition is stable, you will have a physical exam and a detailed exam of your abdomen. 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?
Even Low Dose Of Aspirin Can Cause Intestinal Bleeding
Nov. 9, 2000 — An aspirin a day may prevent heart attack and stroke, but not without potentially serious risks of intestinal bleeding. And now some researchers say that even fairly low doses of aspirin can increase the risk for bleeding in the gut.
While the risk of bleeding associated with long-term aspirin use has been widely recognized, it now appears that even fairly low doses — which some people may have considered safe — increases the risk, say Yoon Kong Loke, MBBS, and Sheena Derry, MBBS, of the department of clinical pharmacology at the University of Oxford in England.
“We have known for a long time that patients on aspirin face the risk of gastrointestinal bleeding,” Loke tells WebMD. “Doctors have tried to get around this problem by recommending the use of smaller doses. Many people believe that the low doses of aspirin, such as 75 mg a day, carry little risk of side effects as compared to the 300 mg and 900 mg doses used in the past. To our surprise, we found that low doses of aspirin were just as likely to cause gastrointestinal bleeding as the high doses.”
Loke also has disappointing news for those hoping to duck the risk of bleeding by using so-called “enteric-coated” aspirin, which have been considered to be somewhat safer than regular aspirin: They aren’t. “We found no evidence that these formulations reduced the risk of gastrointestinal bleeding,” he tells WebMD.
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What Questions Should I Ask My Doctor
If you have stomach ulcers, you may want to ask your doctor:
- What pain reliever can I use instead of an NSAID?
- How will I know if the H. pylori infection is gone?
- How do we find out if the ulcer has healed?
- What can I do relieve symptoms at home during treatment?
A note from Cleveland Clinic
Contrary to commonly held beliefs, ulcers arent caused by stress or foods you eat. Most of time, bacteria causes them. Doctors can treat the bacteria with antibiotics and other medications.
If youve been popping a lot of antacids lately, youre constantly snacking to get rid of a gnawing pain in your stomach or you have any other signs of an ulcer, the best thing you can do for your health is talk to your provider. Treatment can heal an ulcer in a matter of weeks.
Diagnosis Of Ulcers In Horses
If you suspect your horse has a gastric ulcer, make an appointment with your veterinarian. An ulcer can be serious, and sometimes fatal if medical attention is not given in time. Your medical professional will ask questions pertaining to his health history, look closely at his clinical signs, perform blood work, urinalysis, biochemistry profile, and other laboratory testing in order to rule out any other illnesses and come to a preliminary diagnosis.
Your doctor may perform specific diagnostic testing using enhanced diagnostic equipment. He may use a gastroscope, which is an approximately 2 meters-long endoscope into the stomach of your horse. This is currently the most accurate and definitive diagnostic test used to confirm the presence of a stomach ulcer or ulcers.
This test will confirm the specificities of the ulcers, such as size, severity, and precise location. Typically, ulcers are found in the upper portion of the organ however, ulcers can also be found in the lower section, including the duodenum. The ulcer will be classified between the areas of 0-4, with a 4 having severe lesions. He will communicate with you the extent of the ulcer and let you know the options for treatment.
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Why Does Gi Bleeding Happen
In upper GI bleeding, stomach acid can irritate the lining of the esophagus to the point of causing bleeding. In other cases, retching and vomiting can cause a tear in the lining of the lower esophagus , or abnormal veins can be present if there is a liver problem.
Ulcers in the stomach and duodenum can be due to irritation from certain medications, such as aspirin or from infection, particularly from the bacteria, H.pylori.
Uncommon sources are polyps and abnormal blood vessels.
In lower GI bleeding, straining and passage of a hard or wide stool can injure the lining of the rectum and result in bleeding. In the case of colitis, ulcers are deep enough to break the blood vessels, as the lining is inflamed and delicate. Polyps are finger-like overgrowths of the lining of the intestine and bleed when the stool rubs against them.
- Bright red blood coating the stool
- Dark blood mixed with the stool
- Black or tarry stool
- Bright red blood in vomit
- Coffee-grounds appearance of vomit
Other signs, which also need a doctorâs attention, include:
The location of the bleeding may affect what you notice.
If it comes from the rectum or the lower colon, bright red blood will coat or mix with your 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.
If bleeding is hidden, you might not notice any changes in stool color.
Indigestion That Doesnt Go Away And Burping
You can get indigestion when acid from the stomach goes back up into the food pipe . Or you can get it if you have any irritation in your stomach. This often happens after eating .
Remember, indigestion is common and its not usually caused by cancer. Indigestion and heartburn can be very painful, even if nothings seriously wrong. See your doctor if youve had heartburn most days for 3 weeks or more.
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What Can Be Done To Relieve Symptoms
If you believe you may have GI bleeding, its important to talk with a doctor. If the bleeding is serious, you may need emergency care to determine the cause and treat the condition. If your bleeding is serious, you may be admitted to the hospital.
Testing can be useful, not only in diagnosing GI bleeding but also for treating it.
Special scopes with cameras and laser attachments, along with medications, can be used to stop the bleeding. In addition, the doctor can use tools alongside scopes to apply clips to the bleeding vessels to stop the bleeding.
If hemorrhoids are the cause of your bleeding, over-the-counter treatments might work for you. If you find that OTC remedies dont work, a doctor might use a heat treatment to shrink your hemorrhoids, or in severe cases, a surgical procedure to remove them.
Antibiotics can usually treat infections.
How Will My Doctor Treat My Stomach Ulcer
Most stomach ulcers take 1-2 months to heal and your doctor/gastroenterologist will prescribe you the treatment based on the cause of your ulcer.
- Your doctor will assess your family history, dietary history, diseases, and medication history and examine your tummy to address the cause of your stomach ulcer.
- Your doctor will discuss with you the side effects of the painkillers and analgesics, which you may be taking, and whether you should keep using them or stop them.
- Your doctor may advise you to stop smoking, stop alcohol consumption, lose some weight, and avoid some trigger foods, such as spicy and fatty food.
- Your doctor may prescribe an alternative painkiller, analgesic, or anti-inflammatory medications, such as Paracetamol.
- Your doctor will prescribe you proton pump inhibitors and antacids to reduce the amount of acid production and some antibiotics for up to 2 weeks to treat H pylori infection.
- Your doctor will prescribe probiotics, which will help to grow good bacteria in your gut and may be useful in killing H pylori bacteria.
- Your doctor may prescribe you bismuth supplements.
- Your doctor may have another endoscopy to check stomach ulcers several weeks after treatment to make sure that the ulcer is gone because a very small number of stomach ulcers might contain cancer.
If the underlying cause is not addressed properly, the stomach ulcer may recur even after the treatment.
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Can Aspirin Cause Fatal Bleeding
People over 75 taking daily aspirin after a stroke or heart attack are at higher risk of major and sometimes fatal stomach bleeds than previously thought, BBC News reports.
Can aspirin cause stomach problems?
Aspirin can cause ulcers in your stomach or gut, especially if you take it for a long time or in big doses. Your doctor may tell you not to take aspirin if you have a stomach ulcer, or if youve had one in the past.