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Gastrointestinal Bleeding

What is gastrointestinal bleeding?

Gastrointesting (GI) bleeding refers to any bleeding that starts in the gastrointestinal tract. The bleeding can come from any site along the entirety of the GI tract, and is often divided into two categories:

  • Upper GI bleeding (UGIB): the upper GI tract includes the esophagus (food pipe), the stomach, and the first part of the small intestine known as the duodenum.
  • Lower GI bleeding (LGIB): the lower GI tract consists of that majority of the small intestine and the large intestine, rectum, and anus.

Sometimes GI bleeding is obvious and at other times it may be microscopic to the point where it can only be detected on a lab test known as an occult blood test, typically done in the stool. GI bleeding may be seen as:

  • Hematemesis: vomiting blood, whether it is bright red or coffee colored
  • Hematochezia: passage of fresh blood from the rectum, large or small amounts.
  • Melena: dark, tarry stools.

Significant bleeding from the GI tract can be life-threatening. Small but chronic bleeding from the GI tract can lead to anemia, or low number of red blood cells.

What causes gastrointestinal bleeding?

UGI bleeding may be due to (but not limited to):

  • Stomach ulcers
  • Arteriovenous malformations (AVMs)
  • Esophagitis
  • Esophageal varices
  • Mallory-Weiss tear
  • Gastritis

LGI bleeding may be due to (but not limited to):

  • Anal fissure
  • Hemorrhoids
  • Polyps
  • Arteriovenous malformations (AVMs)
  • Inflammatory Bowel Disease, such as Crohn's disease or Ulcerative colitis
  • Meckel's diverticulum
  • Intussusception (bowel telescoping on itself)

How is gastrointestinal bleeding treated?

The treatment of gastrointestinal bleeding is dependent on the cause and the location of the bleeding. Sometimes the reason is obvious without requiring further testing or imaging. Medications might be used to decrease the stomach's acid production to allow the mucosal lining to heal. Some common tests to evaluate gastrointestinal bleeding in children include:

  • Upper endoscopy
  • Capsule endoscopy
  • Colonoscopy
  • Meckel scan