What Is Upper And Lower Gastrointestinal Bleeding?
Gastrointestinal Bleeding occurs when mucosal layer of gastrointestinal system is inflamed or eroded to form a single or multiple bleeding ulcers.
The following organs are present in the digestive tract:
- Small intestine
- Large intestine
Gastrointestinal Bleeding can occur in any of the segment of the gastrointestinal system. Bleeding occurring in the esophagus, stomach, or the small intestine is termed as Upper Gastrointestinal Bleeding whereas bleeding occurring in the large intestine, rectum, or anus is termed as Lower Gastrointestinal Bleeding. The amount of bleeding that occurs may be mild to severe resulting in potentially serious condition.
What Are The Causes Of Upper Or Lower Gastrointestinal Bleeding?
Illustrated below are the causes of both Upper Gastrointestinal Bleeding as well as Lower Gastrointestinal Bleeding.
Causes Of Upper Gastrointestinal Bleeding:
The most common cause of this type of bleeding are presence of peptic ulcers which can form anywhere from the esophagus to the small intestine. These ulcers are normally caused due to a bacterial infection. Sometimes, there are enlarged veins in the esophagus, which may tear and cause bleeding. This condition is called as esophageal varieces. If there is a tear in the walls of the esophagus, then it may also cause bleeding. This condition is called as Mallory-Weiss tears.
The other causes of upper GI bleeding are as follows-
- Esophageal varieces
- Gastric ulcer
- Duodenal ulcer
- Ulcerative colitis
- Crohn's disease
- Parasite infection
- Cancer of esophagus, stomach and small intestine.
Causes of Lower Gastrointestinal Bleeding:
A pathological condition called as colitis is the most common cause of Lower Gastrointestinal Bleeding. Colitis is a condition in which there is inflammation of the colon, which may be caused by infection, food poisoning, parasites, or decreased blood supply to the colon. Another condition, which can cause lower gastrointestinal bleeding, is hemorrhoids. An enlarged vein in the rectum or anus is called as a hemorrhoid. These enlarged veins may tear and cause bleeding. The other causes of lower GI bleeding is as follows-
- Ulcerative colitis
- Crohn's disease
- Parasite infection and
- Cancer of large intestine, sigmoid colon, rectum and anus.
What Are The Risk Factors For Upper And Lower Gastrointestinal Bleeding?
Some of the risk factors for development of upper and lower gastrointestinal bleeding are:
- Chronic Smoking- Chronic smokers are at risk for development of gastrointestinal bleeding.
- Alcohol- Abusing alcohol can lead to gastrointestinal bleeding.
- Bleeding Disorder- If an individual has a history of bleeding disorders then he or she is more likely to get gastrointestinal bleeding.
- Medication Side Effects- Chronic prolonged use of steroids, blood thinners, NSAIDs, or aspirin tends to cause gastrointestinal bleeding.
- Post Surgery Complications- If an individual has a history of a surgical procedure to the GI tract then that individual is also at an increased risk for gastrointestinal bleeding.
- Asymptomatic GI Diseases- If an individual has a prior history of Gastrointestinal Bleeding then it also predisposes that individual to further bleeding episodes. Person with prior history of ulcers is also at increased risk for developing Gastrointestinal Bleeding
- GI infection- If an individual has a prior history of bacterial infections like H. Pylori then there is an increased risk for developing Gastrointestinal Bleeding.
What Are The Symptoms Of Upper And Lower Gastrointestinal Bleeding?
There are a few standout symptoms, which suggest Gastrointestinal Bleeding. There is presence of black tarry stools if an individual has an upper gastrointestinal bleeding. The individual may also have blood in the stools, in medical terms known as bright red blood from rectum, which is also a telltale sign that there is Gastrointestinal Bleeding. If an individual has any of these symptoms then prompt medical evaluation is required as this bleeding may advance to potentially life threatening condition if not treated soon enough. Some additional symptoms, which require immediate medical attention, are coffee ground emesis, paleness, extreme weakness, or shortness of breath. List of symptoms are as follows-
- Abdominal pain
- Anemia causing feeling weakness, dizziness and fainting because of low hemoglobin
- Black tarry stool
- Frank blood in stool
- Nausea and vomiting.
How Is Upper And Lower Gastrointestinal Bleeding Diagnosed?
During initial office visit the treating physician will begin by taking a detailed history about the onset of symptoms and present history of illness. Physician will conduct detailed physical examination. The next step in confirming the diagnosis will be to conduct a test of the stool to look for presence of blood in the stool. The physician may also order a routine blood test to investigate cause of anemia, which could be secondary to blood loss.
Best investigational method to diagnose upper gastrointestinal bleeding is to conduct direct examination of esophagus, stomach and duodenum by using tiny tubular camera. The technique is known as endoscopy and equipment carrying internal camera is known as endoscope. In this procedure, a long tube fitted with a camera is inserted through the throat into the upper gastrointestinal tract and the physician will take a look at the mucosal layer of esophagus, stomach, duodenum and small intestine. The aim of the study is to look for a source of bleeding. Upper GI Endoscopy is only limited to the examination of upper gastrointestinal tract. Examination may not find an active bleeding but may help to diagnose possible cause of bleeding like ulcer or mucosal inflammation.
Similarly the best investigational procedure to diagnose Lower Gastrointestinal Bleeding is colonoscopy. In this procedure, a tiny tube of 2 to 10 mm diameter fitted with a camera is inserted into the colon through the rectum. The physician will take a look at the inner surface of the colon for ulcer, mucosal inflammation, cancer or bleeding diverticulum. Physician will take a tiny piece of mucosa for lab study and procedure is known as biopsy.
What Are Treatments For Upper And Lower Gastrointestinal Bleeding?
Treatment of Gastrointestinal Bleeding Due To Peptic Ulcer- Gastric and duodenal ulcer is treated with antacids, acid blocker (Zantac and Pepcid) and proton pump blockers. Ulcer, which does not respond to medication, is treated with laser or cauterizing of the ulcer. Large ulcer is excised by surgery.
Treatment of Gastrointestinal Bleeding Due To Gastrointestinal Infection- Infection is treated with antibiotics and anti-parasite medication.
Treatment of Gastrointestinal Bleeding Due To Ulcerative Colitis- The mucosal inflammation and ulcer is treated with anti-inflammatory medications like Aminosalicylates, Sulfasalazine and Corticosteroids. The severe ulcerative colitis is treated with immune-suppressants like Cyclosporine, Azathioprine, Methotrexate and Remicade.
Treatment of Gastrointestinal Bleeding Due To Crohn's Disease- Treatment is same as ulcerative colitis.
Cancer of esophagus, stomach and small intestine- Cancer is treated with chemotherapy and surgery.
Hemorrhoids- In case if hemorrhoids are the reason for Gastrointestinal Bleeding, then over-the-counter medications are quite useful. If these over the counter measures are not useful then the physician may use heat treatments to shrink the hemorrhoids.
Home Remedies For Upper And Lower Gastrointestinal Bleeding
Some of the natural methods for treating gastrointestinal bleeding are as mentioned below:
- Aloe Vera Juice For Treating Gastrointestinal Bleeding Naturally: This has shown to increase healing of Gastrointestinal Bleeding. It also calms down inflammation of the intestines, promotes healing of wounds, and makes the tissue more flexible. It also has certain antiviral properties, which is quite useful for gastrointestinal bleeding. Before taking the juice one should make sure that the juice is devoid of any preservatives and its laxative component should also be removed. The recommended dosage of this juice is about a quarter of a cup up to three times a day on an empty stomach.
- Coenzyme Q10: This is an extremely potent antioxidant, which facilitates tissue repair due to damage caused to the tissues by gastrointestinal bleeding. The normal dose recommended is between 30 mg to 60 mg a day. The effects of this medication can better be seen if it is used with omega 3 fatty acids
- Omega 3: Supplements that contain fish oil, flaxseed oil, and hemp seed oil have omega-3 in them. These have proved to be extremely successful in treatment of bowel diseases and gastrointestinal bleeding. The recommended dosage is about one tablespoon of fatty acid in the flaxseed oil or the fish oil form everyday. This can go up to seven tablespoons if tolerated
- N-Acetyl Glucosamine: This substance is naturally found in the body and is formed from glucose. It is extremely beneficial in healing of the intestinal mucosal which get damaged due to Gastrointestinal Bleeding. Recommended dosage is about 6 capsules a day.