Bleeding in the Digestive Tract
How Is Bleeding in the Digestive Tract Recognized?
The signs of bleeding in the digestive tract depend on the site and severity of bleeding.
If blood is coming from the rectum or the lower colon, bright red blood will coat or mix with your stool. The stool may be mixed with darker blood if the bleeding is higher up in the colon or at the far end of the small intestine.
When there is bleeding in the esophagus, stomach, or duodenum, the stool is usually black, tarry, and very foul smelling. Vomit may be bright red or have a "coffee-grounds" appearance when bleeding is from the esophagus, stomach, or duodenum.
If bleeding is occult, or hidden, you might not notice any changes in stool color.
If sudden massive bleeding occurs, a person may feel weak, dizzy, faint, short of breath, or have cramp-like abdominal pain or diarrhea. Shock may occur, with a rapid pulse and drop in blood pressure. You may become very pale.
If bleeding is slow and occurs over a long period of time, a gradual onset of fatigue, lethargy, shortness of breath, and pallor (or paleness of the skin) from anemia will result. Anemia is a condition in which the blood's iron-rich substance, hemoglobin, is diminished.
Note that iron and some foods, such as beets, can give the stool a red or black appearance, falsely indicating blood in the stool.
What Are the Symptoms of Bleeding in the Digestive Tract?
Any of the following symptoms could indicate bleeding in the digestive tract:
- Bright red blood coating the stool
- Dark blood mixed with the stool
- Black or tarry stool
- Bright red blood in vomit
- "Coffee-grounds" appearance of vomit
Other signs may indicate the presence of bleeding in the digestive tract and require further investigation. These include:
- Fatigue, weakness, pale appearance
How Is Bleeding in the Digestive Tract Diagnosed?
If you notice any abnormal bleeding, make an appointment to see your doctor. Your doctor will ask you many questions and perform a physical examination. Symptoms such as changes in bowel habits, stool color (black or red), consistency and the presence of pain or tenderness may tell your doctor which area of the GI tract is affected.
The doctor will test the stool for blood before offering a diagnosis. A blood count will indicate whether you are anemic and also will give an idea of the extent of the bleeding and how chronic it may be.
Your doctor will likely perform an endoscopy. Endoscopy is a common procedure that allows your doctor to directly view the site of the bleeding. In many cases, the doctor can use the endoscope to treat the cause of bleeding as well. The endoscope is a flexible instrument that can be inserted through the mouth or rectum to allow visualization (and possible tissue sampling or biopsy, or treatment) of the areas of concern.
Several other procedures may be used to locate the source of bleeding, including:
- X-rays. During these tests you either drink or have barium-containing fluid placed through the rectum and then X-ray is used to look for any abnormalities. Barium lights up on X-ray.
- Angiography. With this technique, a material that lights up with a special camera is injected into the veins to highlight blood vessels so the doctor can look for the site of the bleeding. In selected situations, angiography allows injection of medication that may stop the bleeding.
- Radionuclide scanning. This is a noninvasive screening technique that can be used for locating sites of bleeding, especially in the lower digestive tract. This technique involves injecting small amounts of radioactive material before pictures of the organs are taken with a special camera.