Gastrointestinal bleeding is a condition when bleeding occurs in the digestive tract. This condition can occur in the upper digestive tract, such as the esophagus (esophagus), stomach, and duodenum. Bleeding can also occur in the lower digestive tract, such as the small intestine, large intestine, and rectum.
Gastrointestinal bleeding symptoms can develop slowly over a long period of time (chronic), and can also occur immediately (acute). In acute gastrointestinal bleeding, symptoms can be seen with the naked eye, such as:
- Vomiting blood, with a bright red or dark brown blood color.
- Bleeding in the rectum, so that sometimes the stool contains blood.
- Stools are dark in color, with a mushy texture.
In contrast, in chronic gastrointestinal bleeding, symptoms can be difficult to detect. Symptoms can include chest pain, stomach pain, dizziness, shortness of breath, and fainting.
If the bleeding gets worse quickly, the patient may experience symptoms of shock, such as:
- Blood pressure drops drastically
- Heart palpitations (more than 100 beats per minute)
- Cold sweats (diaphoresis)
- Frequency of urinating infrequently and little
- Loss of consciousness.
Causes of Gastrointestinal Bleeding
The causes of gastrointestinal bleeding vary widely, depending on the area where the bleeding occurs. In upper gastrointestinal bleeding, causes include:
- stomach ulcer. Gastric ulcers are sores that form in the stomach wall. This condition is the most common cause of bleeding in the upper gastrointestinal tract. Sores can also form on the wall of the duodenum, called duodenal ulcers.
- Esophageal varicose veins rupture. Esophageal varices are enlarged veins in the oesophagus or oesophagus.
- Mallory-Weiss syndrome. Mallory-Weiss syndrome is a condition characterized by tears in the tissue, in the area of the esophagus that borders the stomach.
- Esophagitis. Esophagitis is inflammation of the esophagus, which can be caused by: gastroesophageal reflux (GERD) or acid reflux disease.
- Tumor. Benign tumors or malignant tumors that grow in the esophagus or stomach can cause bleeding.
While lower gastrointestinal bleeding can be caused by a number of the following conditions:
- Inflammation of the intestine. Inflammation of the intestines is one of the most common causes of lower GI bleeding. A number of conditions that include inflammatory bowel disease are Crohn's disease and ulcerative colitis.
- Diverticulitis. Diverticulitis is an infection or inflammation of the diverticula (small pouches that form in the digestive tract).
- Hemorrhoids (hemorrhoids). Hemorrhoids are swollen veins in the rectum or the lower part of the rectum.
- Anal fissure. An anal fissure is an open wound in the anal canal.
- Proctitis. Proctitis is inflammation of the rectal wall, which can cause rectal bleeding.
- Intestinal polyps. Intestinal polyps are small lumps that grow in the large intestine, and cause bleeding. In some cases, colon polyps can develop into cancer if left untreated.
- Tumor. Benign tumors or malignant tumors that grow in the colon and rectum, can cause bleeding.
Gastrointestinal bleeding diagnosis
Doctors can suspect the patient has gastrointestinal bleeding, if the symptoms experienced by the patient can be seen. However, to confirm the diagnosis, the doctor may run further tests, such as:
- Blood test. Doctors can perform a complete blood count, to determine the number of platelets and measure how fast the patient's blood clotting process is.
- Examination of stool samples. This examination will assist the doctor in determining the diagnosis if the bleeding is not visible to the naked eye.
- Angiography. Angiography is an X-ray examination (X-ray) which is preceded by injection of contrast fluid into the patient's veins. This fluid will help the doctor see the condition of the patient's blood vessels more clearly.
- endoscope. Endoscopy can be performed by inserting an endoscope (a flexible tube equipped with a camera) through the mouth or rectum, or by having the patient swallow a capsule containing a tiny camera, to examine the digestive tract. Endoscopy will be performed by a gastroenterologist.
- Imaging test. Doctors may also run imaging tests, such as CT scans, to look for the source of bleeding.
In rare cases, gastrointestinal bleeding can be quite severe, and the source of the bleeding cannot be determined by the above examination. In this condition, the doctor may perform surgery to view the patient's intestines.
Gastrointestinal Bleeding Treatment
One of the goals of treatment for gastrointestinal bleeding is to replace blood and fluids lost due to bleeding. If the bleeding is severe, the patient may require intravenous fluids and blood transfusions. In patients with blood clotting disorders, doctors may give transfusions of platelets or clotting factors.
Treatment of gastrointestinal bleeding also aims to stop the bleeding. There are several methods to stop bleeding. The doctor will choose one of several methods below, based on the cause and area of bleeding, namely:
- Electrocauterization.Electrocauterization is the act of closing a blood vessel using an electric current to stop bleeding. This method is used for bleeding from peptic ulcers, diverticulitis, or intestinal polyps.
- Sclerotherapy injections. Injection sclerotherapy is done by injecting a drug, such as polidocanol or sodium tetradecyl sulfate, into a vein in the esophagus. This method is used to treat bleeding due to esophageal varices or hemorrhoids.
For cases of upper gastrointestinal bleeding, patients can be given PPI injections (proton pump inhibitor), such as esomeprazole, to suppress gastric acid production. Once the source of the bleeding is known, the doctor will determine whether or not to continue the PPI.
Gastrointestinal bleeding complications
Gastrointestinal bleeding can lead to a number of serious complications if not treated promptly. In cases of chronic gastrointestinal bleeding, sufferers may develop anemia, a potentially life-threatening condition of red blood cell deficiency.
Meanwhile, in acute gastrointestinal bleeding that is not treated quickly, the patient will lose blood quickly. This condition causes dizziness and weakness. Patients may also experience abdominal pain and shortness of breath. If this condition is not treated, the risk of shock that leads to death will increase.
Prevention of Gastrointestinal Bleeding
Prevention of gastrointestinal bleeding depends on the underlying cause, including the following:
- Eat healthy and high-fiber foods, such as whole grains, vegetables and fruits
- Don't push too hard when you have a bowel movement
- Try not to lie down after eating, at least 2 hours, to prevent stomach acid from rising
- Consult about aspirin with a doctor before taking it, because it is at risk of causing stomach ulcers.
- Perform colonoscopy as recommended to prevent colon cancer
- Avoid consuming alcoholic beverages
- Drink a lot of water
- Quit smoking.