Gastrointestinal bleeding

Gastrointestinal bleeding
Gastrointestinal bleeding

A positive fecal occult blood test
ICD-10 K92.2
ICD-9 578.9
DiseasesDB 19317
MedlinePlus 003133
eMedicine radio/301 radio/302 emerg/381
MeSH D006471

Gastrointestinal bleeding or gastrointestinal hemorrhage describes every form of hemorrhage (loss of blood) in the gastrointestinal tract, from the pharynx to the rectum. It has diverse causes, and a medical history, as well as physical examination, generally distinguishes between the main forms. The degree of bleeding can range from nearly undetectable to acute, massive, life-threatening bleeding.

Initial emphasis is on resuscitation by infusion of intravenous fluids and blood transfusion, treatment with proton pump inhibitors and occasionally with vasopressin analogues and tranexamic acid. Upper endoscopy or colonoscopy are generally considered appropriate to identify the source of bleeding and carry out therapeutic interventions.



Gastrointestinal bleeding can range from microscopic bleeding, where the amount of blood is so small that it can only be detected by laboratory testing (in the form of iron deficiency anemia), to massive bleeding where pure blood is passed and hypovolemia and shock may develop, risking death.


The causes of upper GI bleed is different from that for lower GI bleeds.

Differential diagnosis

Gastrointestinal bleeding can be roughly divided into two clinical syndromes.

Upper gastrointestinal

Upper gastrointestinal bleeding is from a source between the pharynx and the ligament of Treitz. An upper source is characterised by hematemesis (vomiting up blood) and melena (tarry stool containing altered blood).

Lower gastrointestinal

Lower gastrointestinal bleeding may be indicated by red blood per rectum, especially in the absence of hematemesis. Isolated melena may originate from anywhere between the stomach and the proximal colon.

Diagnostic approach

Diagnosis is often based on direct observation of blood in the stool. This can be confirmed with a fecal occult blood test.


Initial focus in any patient with a form of gastrointestinal hemorrhage is on resuscitation, as any further intervention is precluded by the presence of intravascular depletion or shock.


After adequate stabilization, endoscopy (upper endoscopy and/or colonoscopy) are used to identify the source of bleeding. Injection, sclerotherapy, electrocoagulation, vascular clipping and biopsy may be performed.

Endoscopy is also useful in setting the indication for therapy, e.g. the need for long-term proton pump inhibitor therapy, presence of esophageal varices, adenomatous polyps and so on.


  • Ghosh S, Watts D, Kinnear M. Management of gastrointestinal haemorrhage. Postgrad Med J 2002;78:4-14. PMID 11796865.

Wikimedia Foundation. 2010.

Игры ⚽ Поможем написать реферат

Look at other dictionaries:

  • Upper gastrointestinal bleeding — Upper gastrointestinal (GI) bleeding refers to hemorrhage in the upper gastrointestinal tract. The anatomic cut off for upper GI bleeding is the ligament of Treitz, which connects the fourth portion of the duodenum to the diaphragm near the… …   Wikipedia

  • Lower gastrointestinal bleeding — Infobox Disease Name = PAGENAME Caption = DiseasesDB = ICD10 = ICD10|K|92|2|k|90 ICD9 = ICD9|578.9 ICDO = OMIM = MedlinePlus = eMedicineSubj = radio eMedicineTopic = 301 MeshID = Lower gastrointestinal bleeding, commonly abbreviated LGIB, refers… …   Wikipedia

  • obscure gastrointestinal bleeding — persistent or recurrent gastrointestinal bleeding when a standard endoscopic evaluation is negative; it may be either overt, with melena or hematochezia, or occult, with anemia or a positive test for occult blood …   Medical dictionary

  • Bleeding — Infobox Disease Name = Bleeding Caption = DiseasesDB = ICD10 = ICD9 = ICD9|456.20 ICDO = OMIM = MedlinePlus = eMedicineSubj = eMedicineTopic = MeshID = Bleeding, technically known as hemorrhaging/haemorrhaging (see American and British spelling… …   Wikipedia

  • Rectal bleeding — can refer to: * Lower gastrointestinal bleeding * Hematochezia * Fecal occult blood * Melena …   Wikipedia

  • GIB — gastrointestinal bleeding …   Medical dictionary

  • GIB — • gastrointestinal bleeding …   Dictionary of medical acronyms & abbreviations

  • Fecal occult blood — Classification and external resources Cards and bottle used for the Hemoccult test, a type of stool guaiac test. ICD 10 R …   Wikipedia

  • Aspirin — Asprin redirects here. For the author, see Robert Asprin. Aspirin …   Wikipedia

  • Hemosuccus pancreaticus — Hemosuccus pancreaticus, also known as pseudohematobilia or Wirsungorrhage is a rare cause of hemorrhage in the gastrointestinal tract. It is caused by a bleeding source in the pancreas, pancreatic duct, or structures adjacent to the pancreas,… …   Wikipedia

Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”