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.
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:
Signs of bleeding in the lower digestive tract include:
Sudden, severe bleeding is called acute bleeding. If acute bleeding occurs, symptoms may include:
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.
A variety of conditions can cause bleeding in the digestive tract. Causes of bleeding in the upper digestive tract include the following:
Causes of bleeding in the lower digestive tract include the following:
1 Common cancer types. National Cancer Institute website. www.cancer.gov/cancertopics/commoncancers#1. Updated May 7, 2009. Accessed October 26, 2009.
The first step in diagnosing bleeding in the digestive tract is locating the site of the bleeding. The doctor will take the patient's complete medical history and perform a physical examination. Symptoms such as changes in bowel habits, black or red stools, and pain or tenderness in the abdomen may tell the doctor which area of the digestive tract is bleeding.
The doctor may need to test the stool for blood. Iron supplements, bismuth subsalicylate (Pepto-Bismol), or certain foods such as beets can give the stool the same appearance as bleeding from the digestive tract. Stool tests can also show bleeding that is not visible to the patient.
A blood test can help determine the extent of the bleeding and whether the patient is anemic.
Nasogastric lavage is a procedure that can be used to determine whether the bleeding is in the upper or lower digestive tract. With nasogastric lavage, a tube is inserted through the nose and into the stomach. The contents of the stomach are removed through the tube. If the stomach contains bile and does not contain blood, the bleeding either has stopped or is likely in the lower digestive tract.
Endoscopy is the most common method for finding the source of bleeding in the digestive tract. An endoscope is a flexible tube with a small camera on the end. The doctor inserts the endoscope through the patient's mouth to view the esophagus, stomach, and duodenum. This examination is called esophagogastroduodenoscopy (EGD). An endoscope can also be inserted through the rectum to view the colon. This procedure is called colonoscopy. The doctor can use the endoscope to do a biopsy, which involves collecting small samples of tissue for examination with a microscope.
Bleeding that cannot be found with endoscopy is called obscure bleeding. The doctor may repeat the endoscopy or use other procedures to find the cause of obscure bleeding.
Enteroscopy is an examination of the small intestine. Because traditional endoscopes cannot reach the small intestine, special endoscopes are used for enteroscopy.
Enteroscopy procedures include
Several other methods can help locate the source of bleeding:
Endoscopy can be used to stop bleeding in the digestive tract. A doctor can insert tools through the endoscope to
Endoscopy does not always control bleeding. Angiography can be used to inject medicine or other material into blood vessels to control some types of bleeding. If endoscopy and angiography do not work, the patient may need other treatments or surgery to stop the bleeding.
To prevent bleeding in the future, doctors can treat the conditions that cause bleeding, such as
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) sponsors research to improve treatment for patients with digestive diseases that cause bleeding in the digestive tract, including diverticular disease, GERD, and inflammatory bowel diseases.
Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit http://www.clinicaltrials.gov/.
American College of Gastroenterology
P.O. Box 342260
Bethesda, MD 20827–2260
You may also find additional information about this topic by visiting MedlinePlus at http://www.medlineplus.gov/.
This publication may contain information about medications. When prepared, this publication included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll–free at 1–888–INFO–FDA (1–888–463–6332) or visit http://www.fda.gov/. Consult your doctor for more information.
Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. This publication was reviewed by David A. Peura, M.D., University of Virginia Health System.
The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory.
National Digestive Diseases Information Clearinghouse
The National Digestive Diseases Information Clearinghouse (NDDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1980, the Clearinghouse provides information about digestive diseases to people with digestive disorders and to their families, health care professionals, and the public. The NDDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about digestive diseases.
Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts.
This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.
NIH Publication No. 10–1133
Page last updated March 27, 2012