What is gastrointestinal bleeding?

Gastrointestinal bleeding is bleeding that occurs anywhere in the digestive tract, also called the gastrointestinal tract, which runs from the mouth to the anus. Blood may be present in vomit or stool. Depending on where the bleeding originates, the blood may be visible or occult, which means that it can be detected only by laboratory testing. The severity of gastrointestinal bleeding varies among individuals depending on the cause. Fresh blood in vomit (hematemesis) suggests lesions in the esophagus (varices). Coffee ground-appearing blood in vomit typically indicates stomach ulcer.

Typically, bleeding from the upper gastrointestinal tract that ‘heads downstream’ manifests as black or tarry stool known as melena. The black color develops because of chemical changes that occur as the blood passes through the digestive tract. The passage of bright red blood from the anus is known as hematochezia and usually results from bleeding from sources that are closer to the anus and rectum.

Common causes of gastrointestinal bleeding are inflammation and infections in the digestive tract, such as gastritis. Mild gastrointestinal bleeding is common with viral infections, and this bleeding will go away as the infection resolves. People with an anal fissure or hemorrhoids may also have mild bleeding that resolves on its own. If severe bleeding occurs, it can result in significant blood loss, leading to symptoms such as lightheadedness, dizziness, fainting, or difficulty breathing.

While gastrointestinal bleeding can be minor, it can also result from severe conditions that are characterized by prolonged bleeding. In these cases, serious complications such as shock can develop. Gastrointestinal bleeding can also occur from cancers in the digestive tract.

Left untreated, severe gastrointestinal bleeding can result in a life-threatening loss of blood. Seek immediate medical care (call 911) for serious symptoms, pale skin or pallor and difficulty breathing, severe abdominal pain, vomiting blood or black material, or change in level of consciousness.

What other symptoms might occur with gastrointestinal bleeding?

Gastrointestinal bleeding may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the digestive tract may also involve other body systems.

Gastrointestinal symptoms that may occur along with gastrointestinal bleeding

Gastrointestinal bleeding may accompany other symptoms affecting the gastrointestinal system including:

Abdominal pain or cramping
Abdominal swelling, distension or bloating
Blood-streaked stools
Bloody stool (the blood may be red, black, or tarry in texture)
Constipation
Diarrhea
Rectal bleeding or blood in the stool (melena)
Vomiting blood or black material resembling coffee grounds

Other symptoms that may occur along with gastrointestinal bleeding

Gastrointestinal bleeding may accompany symptoms related to other body systems including:

Dizziness
Fainting or change in level of consciousness or lethargy
Fatigue
Fever
Pale skin or pallor
Weakness (loss of strength)

Serious symptoms that might indicate a life-threatening condition

In some cases, gastrointestinal bleeding can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

Change in level of consciousness or alertness such as passing out or unresponsiveness
Dizziness
Heart palpitations
Respiratory or breathing problems such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking
Severe abdominal pain
Vomiting blood or black material resembling coffee grounds
Weakness (loss of strength)

What causes gastrointestinal bleeding?

Gastrointestinal bleeding can result from any condition occurring in the digestive tract, either in the upper part (including the esophagus, stomach, and part of the small intestine) or in the lower part (including the rest of the small intestine and the large intestine, colon, rectum, and anus). The bleeding can be evacuated through vomiting or mix with the intestinal contents during defecation. Common causes of gastrointestinal bleeding include inflammation, infection, and underlying disease processes such as Crohn’s disease, diverticular disease, or malignancy. Hemorrhoids and anal fissures are common and usually mild sources of bleeding. Gastrointestinal bleeding may also be the result of internal injuries caused by trauma.

Common causes of gastrointestinal bleeding

Common causes of gastrointestinal bleeding include:

Anal fissures
Angiodysplasia (abnormalities in the intestinal blood vessels)
Colitis (inflammation of the large intestine)
Colon polyps or tumors
Diverticulitis (inflammation of an abnormal pocket in the colon)
Esophageal varices (bleeding distended veins)
Esophagitis (inflammation of the esophagus)
Gastritis (inflammation of the stomach lining)
Hemorrhoids
Peptic ulcer

Other causes of gastrointestinal bleeding

Other causes of gastrointestinal bleeding include:

Angiodysplasia (abnormalities in the intestinal blood vessels)
Bleeding disorders, such as hemophilia or von Willebrand’s disease
Bleeding diverticulum (pouch formed by weakening in the intestinal wall)
Celiac disease (severe sensitivity to gluten from wheat and other grains that causes intestinal damage)
Dysentery (infectious inflammation of the colon causing severe bloody diarrhea)
Inflammatory bowel disease (includes Crohn’s disease and ulcerative colitis)
Medication effects (caused by medications such as warfarin, clopidogrel)
Nosebleed or other sources of swallowed blood (epistaxis)

Serious or life-threatening causes of gastrointestinal bleeding

In some cases, gastrointestinal bleeding may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

Colorectal or anal cancer
Esophageal cancer
Esophageal varices
Internal injury from trauma
Intestinal obstruction
Perforated peptic ulcer (bleeding stomach or intestinal ulcer)
Stomach cancer

Questions for diagnosing the cause of gastrointestinal bleeding

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your gastrointestinal bleeding including:

When did you first notice your gastrointestinal bleeding?
Can you tell where the bleeding is coming from?
Do you have any other symptoms?
What medications are you taking?

What are the potential complications of gastrointestinal bleeding?

Because gastrointestinal bleeding can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including: