Gastrointestinal Tract Bleeding

The most common causes of gastrointestinal tract bleeding are peptic ulcer, gastritis, variceal bleeding in the esophagus and upper stomach, tumors, polyps and diverticula in the colon, and hemorrhoids.

Red or maroon stool can indicate several problems, such as colonic polyps, cancer of the colon, Crohn's disease, and ulcerative colitis. It may also mean blood from the stomach or duodenum, particularly if the bleeding is considerable. If you see blood in your stool or in the toilet, consult your physician. The source of the blood simply may be hemorrhoids but other potential sources should be evaluated. In any event, gastrointestinal tract bleeding should not be ignored.

Vomited blood clearly suggests that the gastrointestinal tract bleeding is from the esophagus, stomach, or duodenum. Any blood that enters the intestines below the duodenum usually does not reflux back into the stomach but passes in the stool. One of the more common explanations for heavy bleeding in the stool in people older than 60 is a painless hemorrhage from a diverticulum in the colon.

Vomiting of bright red blood indicates that the gastrointestinal tract bleeding began shortly before you vomited. If the blood is dark red or appears brown and has the texture of old coffee grounds, the blood has been in your stomach for a longer time. Bleeding that occurs in the stomach or duodenum and exits through the rectum often results in black, sticky, and foul-smelling stools that resemble tar. Licorice or ingestion of iron or bismuth subsalicylate (such as Pepto Bismol) may also turn your stool black.

Often, blood in the stool can be detected only by diagnostic tests because the amount is too little to see (occult blood). Over time, the undetected microscopic gastrointestinal tract bleeding can produce an iron-deficiency anemia that may leave you tired and weak from the loss of hemoglobin and iron in the stool.

If you physician suspects that the bleeding is from the upper part of the gastrointestinal tract, he or she may pass a nasogastric tube into your stomach to see if there is blood in it. Endoscopy may be done to find the source of the bleeding. If your physician believes that the bleeding is from the colon, he or she may obtain an angiogram of the colon or perform colonoscopy depending on the amount of blood found at the site.

Often, the gastrointestinal tract bleeding stops spontaneously; sometimes blood transfusions are necessary. Treatment depends on the cause and severity of the hemorrhage. If the bleeding is due to an esophageal varix, the continuous intravenous infusion of a drug such as vasopressin is often successful, at least in stopping the loss of blood temporarily.