Gastrointestinal Bleeding

Gastrointestinal (GI) bleeding can range from minor microscopic bleeding to life-threatening hemorrhage. The location (upper or lower GI tract) and severity guide diagnosis and treatment.

Table of Contents

Quick Facts

  • ICD-10: K92.2
  • Often emergency: Yes for significant bleeding

When to Call 911

Call 911 for:
  • Large-volume vomiting of blood or coffee-ground material
  • Significant rectal bleeding
  • Black, tarry stools with dizziness or weakness
  • Signs of shock (pale, sweaty, rapid heart rate, fainting)

How Bleeding Appears

  • Hematemesis — vomiting bright red blood or coffee-ground material (upper GI)
  • Melena — black, tarry, foul-smelling stool (upper GI, slow)
  • Hematochezia — bright red blood in stool or from the rectum (lower GI usually; massive upper GI possible)
  • Occult bleeding — not visible; detected by stool tests or iron deficiency anemia

Common Causes

Upper GI

  • Peptic ulcer disease
  • Esophageal varices (from cirrhosis)
  • Erosive gastritis (NSAIDs, alcohol)
  • Mallory-Weiss tear (from forceful vomiting)
  • GI cancers

Lower GI

  • Hemorrhoids and anal fissures
  • Diverticular bleeding
  • Colon polyps or cancer
  • Inflammatory bowel disease
  • Angiodysplasia
  • Infectious colitis

Diagnosis

  • Endoscopy (upper) and colonoscopy (lower) — both diagnostic and therapeutic
  • Stool tests for occult blood and infection
  • Imaging (CT angiography, tagged red cell scan) for active bleeding
  • Blood tests for severity and iron status

Treatment

  • Stabilization with IV fluids and blood transfusion if needed
  • Endoscopic therapy (clips, cautery, injections, band ligation)
  • Acid-suppressing medications for upper GI sources
  • Embolization or surgery for refractory bleeding
  • Treat the underlying cause

Related Conditions

Hemorrhagic Shock

Severe complication

 Peptic Ulcer Disease

Common cause

 Internal Bleeding

Broader category
Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • American College of Gastroenterology. GI Bleeding Guidelines.