Gastrointestinal (GI) bleeding is any type of bleeding that starts in GI tract. It is a leading indication for blood transfusion in Hong Kong.

 

Acute GI bleeding is sudden and can sometimes be severe. Chronic GI bleeding is slight bleeding that can last a long time or may come and go.

 

 

 

Symptoms

Symptoms of gastrointestinal (GI) bleeding may include

• black or tarry stool
• bright red blood in vomit
• vomit that looks like coffee grounds
• cramps in the abdomen
• dark or bright red blood mixed with stool
• Symptoms of anaemia: dizziness or faintness; feeling tired; paleness; shortness of breath; weakness

 

 

Causes

 

GI bleeding can have a range of causes. The following conditions, which are listed in alphabetical order, include possible causes of GI bleeding:

1. Angiodysplasia. Angiodysplasia is a small vascular malformation of the gut. It is a common cause of otherwise unexplained gastrointestinal bleeding and anaemia.
2. Benign tumours and cancer in the oesophagus, stomach, colon, or rectum may cause bleeding when they weaken the lining of the GI tract.
3. Colon polyps. Colon polyps can cause GI bleeding. You can have more than one colon polyp at a time. Some types of polyps may become cancerous. Large benign polyps and cancerous growths, however, can both lead to bleeding.
4. Oesophageal varices can cause GI bleeding. They are most often a consequence of portal hypertension, which is a major complication of liver cirrhosis.
5. Gastroesophageal reflux disease, or GERD, is a chronic digestive disorder that describes the return of the stomach’s contents back into the oesophagus. Stomach acid can cause irritation and inflammation of the oesophagus (esophagitis) that may lead to bleeding.
6. Haemorrhoids or anal fissures. Haemorrhoids are another common cause of GI or rectal bleeding. A haemorrhoid is an enlarged vein in rectum or anus. These enlarged veins can rupture and bleed, causing rectal bleeding. And an anal fissure may also cause lower GI bleeding.
7. Gastric and duodenal ulcers are also more likely to perforate, and therefore, lead to upper GI bleeding.

 

 

Diagnosis

 

Doctor may perform the following tests to help diagnose the cause of GI bleeding.

 

1. Stool tests can show occult bleeding.
2. Blood tests can help determine the extent of the bleeding and whether the patient has anaemia.
3. Endoscopy is a procedure that allows a doctor to view the inside of the patient’s body and to detect the bleeding area. It can perform a procedure to control the bleeding when necessary. Endoscopy is commonly used in upper gastrointestinal tract and colon.

• Upper GI endoscopy. It is a diagnostic endoscopic procedure that visualizes the upper part of the gastrointestinal tract down to the duodenum. Doctor may remove a small tissue (biopsy) if any abnormalities are found and send it to a pathology lab for testing.
• Colonoscopy. During the procedure, a flexible colonoscope with a diameter of around 1.5cm will then be introduced by the endoscopist through the anus to examine the colon. It allows the doctor to take a biopsy or remove polyps during the procedure.

 

 

Treatment

 

If stomach bleeding or rectal bleeding is detected, an endoscopy will be required for further examination. During an upper GI endoscopy, or a colonoscopy, doctor can stop the bleeding in GI tract by inserting tools through an endoscope to inject medicines into the bleeding site, or close affected blood vessels with a band or clip.

When infections or ulcers cause bleeding in the GI tract, doctor can prescribe medicines to treat the problem.

 

 

 

Prevention

 

Citizens are recommended to maintain a healthier lifestyle, control appetite, and quit smoking and alcohol.

 

 

 

*The above information is for reference only, please consult your doctor for detail.