Gastrointestinal (GI) bleeding is a symptom of a disorder in your digestive tract. The blood often appears in stool or vomit but isn’t always visible. The level of bleeding can range from mild to severe and life-threatening. Finding the cause of GI bleeding can be difficult. But sophisticated imaging technology can usually locate the problem, and minimally invasive procedures often can fix it.
GI bleeding can result from a number of digestive disorders, including:
- Peptic ulcers
- Inflammatory bowel disease (IBD)
- Diverticulosis
- Hemorrhoids
- Colon polyps
- Rectal prolapse
- Abnormalities in blood vessels in the digestive tract
- Cancerous tumors
GI bleeding can be visible in the form of vomiting of blood, bright red bloody stools or black tarry stools (melena). Even a small amount of GI bleeding that isn’t visible can result over time in a shortage of red blood cells in your blood (anemia).
Pinpointing the source of GI bleeding can be especially difficult if it starts in the small intestine. When the source can’t be identified, the term obscure GI bleeding is used.
- Esophagogastroduodenoscopy (EGD). A scope is used to inspect your esophagus, stomach and upper part of the small intestine (duodenum). The doctor may remove a small tissue sample (biopsy) for further study.
- Capsule endoscopy. You swallow a small pill containing a video camera, which transmits images of your small intestine to a recording device.
- Balloon-assisted enteroscopy. A specialized scope inspects parts of your small intestine that EGD and colonoscopy can’t reach.
- Endoscopic ultrasound. An ultrasound probe attached to an endoscope allows doctors to see all the layers of tissue in the digestive tract.
- Endoscopic retrograde cholangiopancreatography (ERCP). A scope combined with an X-ray procedure allows doctors to see the ducts of the gallbladder, liver and pancreas.
- A contrast dye is injected into an artery, and a series of X-rays are taken to look for a bleeding vessel or other abnormalities.
If your GI bleeding is severe, and noninvasive tests can’t find the source, you may need surgery so that doctors can view the entire small intestine.
There are a variety of treatment options, depending on the source of your GI bleeding:
- Endoscopic thermal probe can stop bleeding from ulcers and other abnormalities by burning (coagulating) the blood vessel or abnormal tissue.
- Argon plasma coagulation and radio frequency ablation are other types of thermal techniques used to treat abnormal blood vessels in the stomach, small intestine and colon.
- Endoscopic clips can be used to close a bleeding vessel or other defective tissue.
- Endoscopic band ligation >uses special bands to treat bleeding hemorrhoids and bleeding blood vessels (varices) in the esophagus.
- Endoscopic cryotherapy freezes abnormal blood vessels in the stomach.
- Endoscopic intravariceal cyanoacrylate injection uses a special glue to treat difficult bleeding from varices in the stomach.
- Angiographic embolization injects particles directly into a blood vessel to stop bleeding.
If bleeding recurs after treatment, you may need surgery.