Internal Bleeding: An Overview

Medically Reviewed By Darragh O'Carroll, MD
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Internal bleeding, or hemorrhaging, is bleeding inside the body. A damaged blood vessel causes the bleeding. If uncontrolled, internal bleeding is fatal. Internal bleeding usually is a result of trauma. Internal bleeding can be difficult to diagnose because you are unable to see it. Causes of internal bleeding can include bleeding disorders, gastritis, or organ damage.

This overview describes internal bleeding, its symptoms, possible causes, and more.

What is internal bleeding?

bruise on a leg with pink socks
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Internal bleeding is blood loss within the body. Because it is inside the body, internal bleeding may go unnoticed initially. When discovered, internal bleeding needs a high level of supervision from doctors.

If the bleeding is rapid, enough blood may build up to press on internal structures. Bulges or discoloration under the skin may appear. Severe internal bleeding can cause shock and loss of consciousness.

What are the symptoms of internal bleeding?

Symptoms vary based on the location and rate of blood loss. Slow internal bleeding can cause the gradual onset of anemia. This results in initial symptoms such as:

  • energy loss
  • tiredness
  • shortness of breath
  • paleness
  • headache, particularly for bleeding in the head
  • nausea
  • altered mental state

Gastrointestinal bleeding may cause blood in the stool or vomit. Similarly, urinary tract bleeding may make the urine bloody.

Read more about gastrointestinal bleeding and urinary tract bleeding.

Can symptoms resolve on their own?

Although internal bleeding may occasionally resolve on its own, it can have very serious consequences. Generally, treatment involves:

  • stabilization of vital functions, such as circulation and respiration
  • identification of the bleeding site
  • control of blood loss
  • repair of damage related to the bleeding

You may need a blood transfusion if a significant amount of blood has been lost.

When should you contact a doctor?

Internal bleeding can have serious, life threatening consequences. Seek immediate medical care if you, or someone with you, has symptoms such as:

  • bleeding during pregnancy
  • bloody or pink-colored urine or not producing any urine
  • chest pain or pressure or rapid heart rate
  • cold and clammy skin, pale skin or pallor, discoloration of the lips or fingernails
  • confusion or loss of consciousness, even briefly
  • difficulty breathing
  • head injury
  • obvious deformity or broken bones
  • profuse sweating
  • rapid swelling
  • rectal bleeding or bloody stool
  • severe pain
  • vomiting blood

Symptoms accompanying internal bleeding vary based on the location and speed of blood loss. Pain may or may not be present.

Related symptoms may include the following.

In the head

Internal bleeding in the head may accompany other symptoms, including:

In the chest or abdomen

Internal bleeding in the chest or abdomen may accompany other symptoms, including:

Into the muscles or joints

Internal bleeding into the muscles or joints may accompany other symptoms, including:

  • bone or joint abnormality
  • loss of sensation
  • pain
  • reduced mobility
  • swelling, redness, or warmth

At other sites

Internal bleeding at other sites may accompany symptoms such as:

  • abdominal pain or cramping
  • bloody or pink-colored urine
  • red, black, or tarry bloody stool
  • hematoma, collection of blood in body tissues
  • pain
  • vomiting blood or black material that resembles coffee grounds

What causes internal bleeding?

Trauma or a variety of medical conditions can cause internal bleeding. The risk increases with clotting irregularities and anticlotting medications.

Nontraumatic causes

Although internal bleeding can result from trauma, a variety of conditions can cause it, including:

Serious or life threatening causes

In some cases, a serious or life threatening condition may cause internal bleeding, including:

  • bleeding esophageal varices, rupture and hemorrhage of swollen veins in the esophagus
  • bowel infarction, severe bowel injury due to decreased blood supply
  • ectopic pregnancy, pregnancy growing outside the uterus
  • head injury
  • ruptured aortic aneurysm, rupture of a weakened, bulging area of the aorta
  • ruptured liver or spleen
  • trauma such as bone fractures and eye injuries

Read more about ectopic pregnancy.

How do you treat internal bleeding?

Firstly, the goal of treating any internal bleeding is to stop the flow of blood.

Treatment or management of internal bleeding will depend on the location and extent of the injury. Some treatments may include:

  • blood transfusion to replace the loss of blood
  • stopping the bleeding or blood flow
  • repairing damage from the bleeding

More serious cases of internal bleeding can require surgery.

How do doctors diagnose internal bleeding?

To diagnose internal bleeding, your doctor will perform a physical exam and may order procedures such as:

After diagnosis, your doctor will work with you to develop a treatment plan.

What are the potential complications of internal bleeding?

Serious diseases or trauma may cause internal bleeding. Failure to seek treatment can cause serious complications and permanent damage.

If untreated, internal bleeding may lead to these complications:

  • altered or decreased sensation
  • low red blood cell count
  • brain damage
  • organ failure
  • paralysis or weakness
  • shock
  • unconsciousness and coma

It is important to follow the treatment plan designed with your healthcare professional to avoid complications of internal bleeding.

Other frequently asked questions

Here are questions people also ask about internal bleeding.

What are the first signs of internal bleeding?

Some signs of internal bleeding include pain at the injured site, a swollen abdomen, and vomiting.

How long can you survive with internal bleeding?

Even a small hemorrhage can prove fatal. It is important to seek immediate medical care after trauma for the maximum chance of survival.

Why is internal bleeding fatal?

Internal bleeding is fatal as it can result in pressure building in the body, shock, and organ failure.

Summary

Internal bleeding can be a life threatening complication. Medical professionals need to find the cause and source of the bleeding quickly. Internal bleeding is difficult to diagnose because it is not as easy to see as external bleeding. Related symptoms, such as nausea or weakness, may indicate internal bleeding.

You should seek immediate medical care if you have any symptoms after trauma, including vomiting blood, profuse sweating, or dizziness.

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Medical Reviewer: Darragh O'Carroll, MD
Last Review Date: 2022 Jul 25
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