Disease: Gastrointestinal bleeding


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, though it may cause the stool to look black or tarry. The level of bleeding can range from mild to severe and life-threatening.

Bleeding in the stomach or colon can usually be easily identified, but finding the cause of bleeding that occurs in the small intestine 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
  • Abnormalities in blood vessels in the digestive tract
  • Cancerous tumors

GI bleeding can be visible in the form of vomiting blood, having bright red bloody stools or having black tarry stools (melena). Even a small amount of GI bleeding that isn't visible can cause a shortage of red blood cells in your blood (anemia) over time.

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.

Source: http://www.mayoclinic.com


Diagnosis at Mayo Clinic

Mayo Clinic doctors start by asking you about your symptoms and by doing a thorough physical examination and blood tests. This initial exam may be enough to indicate a cause of GI bleeding.

But if the source isn't obvious, Mayo Clinic doctors can use sensitive imaging technologies to find it. Results from one procedure determine the next procedure to use until the cause is determined.

Mayo doctors use these tests:

  • Upper endoscopy. This procedure — also called esophagogastroduodenoscopy — uses a scope to inspect your esophagus and stomach, as well as the upper part of your small intestine (duodenum). The doctor may remove a small tissue sample (biopsy) for further study and in some cases control or treat the bleeding source.
  • Colonoscopy. This test uses a long, flexible tube to provide video images of your rectum and colon. In some cases, bleeding can be controlled or treated during a colonoscopy.
  • 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 esophagogastroduodenoscopy and colonoscopy can't reach. Sometimes, the source of bleeding can be controlled or treated during this test.
  • 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. However, this test is rarely needed in the evaluation of GI bleeding.
  • Multiphase CT enterography or magnetic resonance (MR) enterography. Mayo Clinic researchers helped develop these noninvasive radiologic tests, which are more sensitive than conventional X-rays for finding the source of GI bleeding. These tests can provide images of the entire thickness of the bowel wall, all of the long loops in the small intestine and all layers of surrounding tissue.
  • Angiography. A contrast dye is injected into an artery, and a series of X-rays are taken to look for and treat bleeding vessels 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. Fortunately, this is rare.

Source: http://www.mayoclinic.com

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