Gastrointestinal Bleeding

GENERAL INFORMATION:

What is gastrointestinal (GI) bleeding? Gastrointestinal (gas-troh-in-TES-ti-nal) bleeding may happen when you have another disease or condition. The gastrointestinal (GI) system in your body includes your stomach and your intestines, but GI bleeding can occur anywhere in your digestive (deye-JES-tiv) tract. The digestive tract is the path that food takes through your body as it is digested. Your digestive tract includes your esophagus (e-SOF-ah-gus), stomach, and the large and small intestines (in-TES-tins). The esophagus is the tube that carries food from your mouth to your stomach. The intestines are the tubes that carry food from your stomach to your rectum and anus (rear end).

How is a GI bleed described? Caregivers will check to see where you are bleeding from. They will try to find out how long you have been bleeding. They will also check to see how much blood you have lost. From this information, caregivers may describe your GI bleed as follows:

• Upper GI bleeding - Bleeding in the esophagus, stomach, or the beginning of your small intestine.
  
  
• Lower GI bleeding - Bleeding in the small intestine, large intestine (colon), rectum, or anus.
  
  
• Frank (obvious) bleeding - Active bleeding that can be easily seen. For example, you may vomit blood or see blood in your BM (bowel movement).
  
  
• Occult (hidden) bleeding - Slow bleeding that cannot be seen easily. Tests may be needed to find occult (oh-KULT) bleeding.
  
  
• Acute GI bleeding - Blood loss that is new or sudden, and lasts for only a short time.
  
  
• Chronic GI bleeding - Blood loss that has been going on for a long time, or that comes back often.

What causes GI bleeding?

• Many different things can cause GI bleeding. Bleeding may start because of damage to your digestive tract. This damage may be caused by infections (in-FEK-shuns), alcohol abuse, or certain medicines (such as aspirin). Growths or swollen pockets in your digestive tract may also cause bleeding. You may have bleeding if you have blood vessels that are not normal.
  
  
• Diseases or other health problems may cause GI bleeding. Examples include liver disease, stomach ulcers (sores), inflammatory bowel disease, colitis, cancer, or hemorrhoids (HEM-oh-roids). GI bleeding may happen after an injury, such as a blow to the stomach or hard vomiting (throwing up).

What are the signs and symptoms of GI bleeding?

• Your symptoms depend on where the bleeding is, what is causing it, and how much blood you lose. If you are only losing a little bit of blood, you may have no symptoms. You may have nausea (feeling like you may throw up). You may also have cramping or pain in your abdomen (belly). You may see changes in your vomit or BMs which can include:
  
  
  • Vomiting bright red blood. Blood in the vomit can also be dark red or black. The vomit may look like coffee grounds.
    
    
  • BMs that are sticky, tarry, or black.
    
    
  • You may see bright red blood in your BM, or the water in the toilet may turn red.
    
    
  • You may not pass waste material at all. You may feel like you are going to have a BM, but pass only blood or blood clots into the toilet.
  
  

• Signs and symptoms of losing too much blood may include:
  
  
  • Chest pain, or feeling like your heart is beating too fast.
    
    
  • Extreme tiredness that is new for you and that cannot be explained.
    
    
  • Dizziness or fainting, especially after moving from a sitting or lying position.
    
    
  • Pale skin or gums, and sweaty or clammy skin.
    
    
  • Dry mouth, increased thirst, or passing less urine.
    
    
  • Feeling confused or short of breath.
  
  

How is GI bleeding diagnosed and treated?

• Your GI bleeding may stop on its own. However, it is important for your caregiver to find out why you are bleeding. The tests and treatments you receive will depend upon where the bleeding is and how bad it is. Your caregiver will need to ask you questions about your health, medicines, and lifestyle. You may need to go into the hospital for tests and treatment.
  
  
• You may need an endoscopy (en-DOS-koh-pee) to find or treat your bleeding. A small tube with a light on the end (called a scope) is passed into your digestive tract. This scope can be passed through your mouth or rectum, depending on where your bleeding may be. To stop the bleeding you may also need medicine or surgery. You may need a blood transfusion (trans-FU-zhun) if you have lost a lot of blood.

What are the risks of having GI bleeding? Blood loss from a GI bleed may make other health problems (such as heart or breathing problems) worse. Some diseases or conditions that cause GI bleeding may be life threatening. It is important to be checked by a caregiver, even if your bleeding stops on its own. You may die from a GI bleed if you lose too much blood.

For support and more information: GI bleeding can be a frightening experience for you and your family. Accepting that you have a health problem is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. You can also contact one of the following national organizations for more information.

• International Foundation for Functional Gastrointestinal Disorders
  P.O. Box 170864
  Milwaukee, WI 53217
  Phone: 1-414-964-1799
  Phone: 1-888-964-2001
  Web Address: http://www.iffgd.org
  

• National Digestive Diseases Information Clearinghouse (NDDIC)
  2 Information Way
  Bethesda, MD 20892-3570
  Phone: 1-800-8915389
  Web Address: www.digestive.niddk.nih.gov
  

• American Society for Gastrointestinal Endoscopy (ASGE)
  1520 Kensington Road
  Oak Brook, IL 60523
  Phone: 1-630-573-0600
  Web Address: http://www.asge.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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