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Patient care — conditions, diseases

Gastrointestinal bleeding: A sign of disease or abnormality within the gastrointestinal tract involving the presence of blood or hemoglobin in the stool. Upper GI bleeding is considered any source located between the mouth and outflow tract of the stomach. Lower GI bleeding is considered any source located from the outflow tract of the stomach to the anus (small and large bowel).

Gastrointestinal bleeding can range from microscopic bleeding where the amount of blood is so small that it can only be detected by laboratory testing, to massive bleeding where almost pure blood is passed. Awareness of gastrointestinal bleeding is important as it may herald many significant diseases and conditions. Prolonged microscopic bleeding can lead to massive losses of iron and subsequent anemia. Acute massive bleeding can lead to hypovolemia, shock, and even death.

Gastrointestinal bleeding can occur at any age from birth on. Gastrointestinal bleeding in children ranges from the simple, such as swallowed blood from a nosebleed to the more complex, such as milk allergies, to life-threatening conditions such as intussusception or Meckel's diverticula. Adolescents and young adults may suffer from bleeding ulcers, Crohn's disease, and colitis; while colon cancer and diverticulitis must be considered as potential causes of gastrointestinal bleeding in middle-aged and senior adults.

Causes:

  • air-contrast barium enema
  • arterio-venous malformations (fragile blood vessels)
  • endoscopy or similar tests that involve entering the bowel
  • intestinal volvulus (twisted bowel)
  • intussusception
  • Meckel's diverticula
  • acquired platelet function defect
  • anal fissure
  • cow's milk allergy
  • diarrhea
  • diverticulitis
  • duodenal ulcer
  • epistaxis (nose bleed)
  • esophagitis
  • esophageal varices
  • foreign bodies
  • gastric ulcer or duodenal ulcer
  • gastritis or enteritis
  • gastrointestinal cancer
  • hemolytic-uremic syndrome (HUS)
  • ischemic bowel
  • Crohn's disease (regional enteritis)
  • salmonellosis
  • shigellosis
  • trauma
  • ulcerative colitis

Call your health care provider if:

  • you have black, tarry stools (this may be a sign of gastrointestinal bleeding).
  • you have blood in the stools.
  • you begin vomiting blood or you vomit material that looks like coffee grounds.

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