![]() It is considered a medical emergency, and the most vital distinction is whether there is blood loss sufficient to cause shock. Upper GI Bleeding: Hematemesis is vomiting of red-colored blood and indicates upper GI bleeding, usually from an arterial source or varix. GI bleeding may also precipitate hepatic encephalopathy (brain and nervous system damage caused by liver failure) or hepatorenal syndrome (kidney failure secondary to liver disease). Chronic liver disease due to excessive use of alcohol can also cause bleeding. Several drugs increase the likelihood of bleeding, including nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin, and heparin. Past medical history should also inquire about previously diagnosed or undiagnosed GI bleeding, inflammatory bowel disease (IBD), bleeding diatheses, and liver disease. These include presence of abdominal discomfort, weight loss, easy bleeding or bruising, previous colonoscopy results, and symptoms of anemia (weakness, fatigue, dizziness). To evaluate the patient, there are a number of symptoms that need to be reviewed after GI bleeding. Whether blood was passed with initial emesis or only after several nonbloody vomiting episodes could indicate different causes. However, quantity can be difficult to assess because even small amounts (5-10 mL) of rectal bleeding or modest amounts of vomited blood are alarming to a patient. ![]() History of present illness should be reviewed to ascertain quantity and frequency of blood passage. Upper endoscopy or colonoscopy are generally considered the best methods to identify the source of bleeding. The manifestations depend on the location and rate of bleeding, from nearly undetectable to acute and life-threatening. GI bleeding has a variety of causes, and a review of patient medical history and a physical examination can distinguish between the macroscopic and microscopic forms. It differs from internal bleeding, where blood leaks from the blood vessels in such a way that the bleeding cannot be seen outside of the body. ![]() A type of endoscopy called colonoscopy looks at the large intestine.Gastrointestinal (GI) bleeding can originate anywhere from the pharynx to the rectum and can be occult or overt. It uses a flexible instrument inserted through the mouth or rectum to view the inside of the GI tract. The test used most often to look for the cause of GI bleeding is called endoscopy. There are many possible causes of GI bleeding, including hemorrhoids, peptic ulcers, tears or inflammation in the esophagus, diverticulosis and diverticulitis, ulcerative colitis and Crohn's disease, colonic polyps, or cancer in the colon, stomach or esophagus. GI bleeding is not a disease, but a symptom of a disease. Stool mixed or coated with bright red blood.Signs of bleeding in the lower digestive tract include: Signs of bleeding in the upper digestive tract include: Signs of bleeding in the digestive tract depend where it is and how much bleeding there is. ![]() The amount of bleeding can be so small that only a lab test can find it. Bleeding can come from any of these areas. Your digestive or gastrointestinal (GI) tract includes the esophagus, stomach, small intestine, large intestine or colon, rectum, and anus.
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