Bleeding Digestive Tract

What is Bleeding Digestive Tract?

Bleeding Digestive Tract tract refers to bleeding that occurs in our digestive system. It occurs in digestive organs such as oesophagus, stomach, small intestine and large intestine. It is caused by diseases that damage our digestive system, resulting in bleeding. 

Severe bleeding in and of itself can be life-threatening and often require urgent life-saving procedures. 

While minor bleeding does not pose an immediate danger, it may be caused by significant diseases such as cancer and inflammation and still should not be taken lightly. Sometimes bleeding is the only symptom of these important diseases. 

SYMPTOMS

The symptoms of bleeding digestive tract include the following

  • Hematemesis: vomiting fresh red blood or vomiting “coffee ground” vomitus
  • Passing of pitch-black, tar-like stool that has a distinctive fishy smell. The stool is also known as melena. 
  • Passing blood from the anus: the blood can be fresh-red or darker; it can also be mixed with stool or discovered during wiping.

A significant amount of bleeding will result in low blood pressure, manifesting as giddiness or “black-out”. This is often accompanied by some abdominal cramps. 

WHEN to See a Doctor

You should always see a doctor to properly evaluate a bleeding digestive tract. It can be caused by simple conditions such as piles but it can also be caused by cancer or other critical diseases. It is far better to get a professional to evaluate.

If you have severe bleeding digestive tract (i.e. passed out a large amount of blood or dark stool and feeling giddy and have a heart rate >100 beats/min) you should go to the emergency department of the hospital. Call an ambulance if necessary. Do not eat anything because endoscopic examination requires fasting of 6 hours.

CAUSES

Bleeding of the upper digestive tract can be a result of diseases such as:

  • Stomach and duodenum ulcer
  • Abnormal, enlarged vessel in the oesophagitis or stomach due to liver hardening (called varices)
  • Reflux oesophagitis
  • Tear of the oesophagitis from severe retching and vomiting
  • Abnormal blood vessels in the stomach
  • Cancer of the oesophagitis or stomach
  • Bleeding from the bile ducts


Bleeding of the lower digestive tract can be a result of diseases such as:

  • Piles or haemorrhoids
  • Cancer of the colon
  • Large colonic polyps
  • Diverticulosis
  • Abnormal blood vessels of the colon
  • Inflammation of the colon from infection or inflammatory bowel disease
RISK FACTORS

You will have a higher risk of complications if you are above the age of 65.

Taking medication such as anti-platelet or anti-coagulation will increase your risk of having a bleeding digestive tract. These medications are commonly known as “blood thinner”, they are often used in heart diseases, stroke and diseases associated with blood clots. Some medications will result in more fragile blood vessels and increase your risk of bleeding.

Disorders, that are either inherited or acquired, can interfere with clotting and increase the risk of GI bleeding. Having renal impairment or significant liver diseases interferes with the body’s ability to stop bleeding and also increases the risk of GI bleeding.

DIAGNOSIS

Diagnosis of the exact cause of bleeding digestive tract needs investigations such as gastroscopy and colonoscopy. These are slim instruments with a camera, light and channel for the instrument that is inserted through the mouth or anus to examine the digestive tract. 

CT angiogram uses a CT scan and injection of contrast. This is useful in bleeding of the lower digestive tract and small intestine. 

The second line of investigation will include an MRI of the small intestine and capsule endoscopy (where a small camera that takes about 50000 pictures in the small intestine over a few hours is swallowed). Small intestinal endoscopy is also available as a tool.

TREATMENT

Treatment consists of the following:

  1. Supportive treatment (if needed) includes saline infusion, blood product infusion, oxygen and in some instances, medication that supports blood pressure. Antibiotics are needed in some conditions. Medication that helps with clotting may be needed at times.
  2. To stop the bleeding. Usually, therapeutic endoscopy is needed to stop the bleed within 24 hours. Sometimes a therapeutic radiological procedure may be needed.
  3. Treatment for the underlying cause of the bleed may be necessary so that bleeding will not recur.