NYC GI Doctors Specialists in the Treatment of Hemorrhoids and Anal Warts in New York City

Gastrointestinal Bleeding

Bleeding in the digestive tract is a symptom of a disease rather than a disease itself. A number of different conditions can cause bleeding. Most causes of bleeding are related to conditions that can be cured or controlled, such as ulcers or hemorrhoids. Some causes of bleeding may be life threatening.

Locating the source of bleeding is important. Different conditions cause bleeding in the upper digestive tract and the lower digestive tract. The upper digestive tract includes the esophagus, stomach, and upper portion of the small intestine, also called the duodenum. The lower digestive tract includes the lower portion of the small intestine; large intestine, which includes the colon and rectum; and anus.


What are the signs of bleeding in the digestive tract?

The signs of bleeding in the digestive tract depend on the site and severity of bleeding.

Signs of bleeding in the upper digestive tract include:

  • bright red blood in vomit
  • vomit that looks like coffee grounds
  • black or tarry stool
  • dark blood mixed with stool
  • stool mixed or coated with bright red blood

Signs of bleeding in the lower digestive tract include:

  • black or tarry stool
  • dark blood mixed with stool
  • stool mixed or coated with bright red blood

Sudden, severe bleeding is called acute bleeding. If acute bleeding occurs, symptoms may include:

  • weakness
  • dizziness or faintness
  • shortness of breath
  • crampy abdominal pain
  • diarrhea
  • paleness

A person with acute bleeding may go into shock, experiencing a rapid pulse, a drop in blood pressure, and difficulty producing urine.

Light bleeding that continues for a long time or starts and stops is called chronic bleeding. If bleeding is chronic, a person may notice that fatigue, lethargy, and shortness of breath develop over time. Chronic blood loss can also lead to anemia, a condition in which the blood’s iron-rich substance, hemoglobin, is diminished.

A person may not notice a small amount of bleeding in the digestive tract. This type of bleeding is called occult bleeding. Simple tests can detect occult blood in the stool.


What causes bleeding in the digestive tract?

A variety of conditions can cause bleeding in the digestive tract. Causes of bleeding in the upper digestive tract include the following:

  • Peptic ulcers. Helicobacter pylori (H. pylori) infections and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, are common causes of peptic ulcers.
  • Esophageal varices. Varices, or enlarged veins, located at the lower end of the esophagus may rupture and bleed massively. Cirrhosis is the most common cause of esophageal varices.
  • Mallory-Weiss tears. These tears in the lining of the esophagus usually result from vomiting. Increased pressure in the abdomen from coughing, hiatal hernia, or childbirth can also cause tears.
  • Gastritis. NSAIDs and other drugs, infections, Crohn’s disease, illnesses, and injuries can cause astritis—inflammation and ulcers in the lining of the stomach.
  • Esophagitis. Gastroesophageal reflux disease (GERD) is the most common cause of esophagitis—inflammation and ulcers in the lining of the esophagus. In GERD, the muscle between the esophagus and stomach fails to close properly, allowing food and stomach juices to flow back into the esophagus.
  • Benign tumors and cancer. A benign tumor is an abnormal tissue growth that is not cancerous. Benign tumors and cancer in the esophagus, stomach, or duodenum may cause bleeding.

Causes of bleeding in the lower digestive tract include the following:

  • Diverticular disease. This disease is caused by diverticula—pouches in the colon wall.
  • Colitis. Infections, diseases such as Crohn’s disease, lack of blood flow to the colon, and radiation can cause colitis—inflammation of the colon.
  • Hemorrhoids or fissures. Hemorrhoids are enlarged veins in the anus or rectum that can rupture and bleed. Fissures, or ulcers, are cuts or tears in the anal area.
  • Angiodysplasia. Aging causes angiodysplasia—abnormalities in the blood vessels of the intestine.
  • Polyps or cancer. Benign growths or polyps in the colon are common and may lead to cancer. Colorectal cancer is the third most common cancer in the United States and often causes occult bleeding.1
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