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Gastrointestinal Bleeding

Gastrointestinal (GI) bleeding refers to blood loss at any place along the GI tract. The GI tract includes the mouth, esophagus, stomach and small and large intestines and rectum. Bleeding from the GI tract may be severe enough to require a visit to the Emergency Room, admission to the hospital, or in very severe cases, admission to the Intensive Care Unit (ICU).

GI bleeding is usually noticed by the vomiting of actual blood or material that looks like coffee-grounds, or by the passage of blood in the stool, which can appear as actual blood or as a black or maroon discoloration to the stool. With rapid bleeding, patients frequently feel lightheaded, dizzy or sweaty. In contrast, slower bleeds can cause patients to become pale, weak and short of breath.

Common causes of "upper" GI bleeding (usually referring to the esophagus, stomach or first part of the small intestine) include irritation of the lining of these organs and ulcers, often from certain medications, alcohol use or certain bacterial infections. "Lower" GI bleeding (originating from the rest of the small intestine and the large intestine or colon) is frequently caused by diverticulosis (pouches in the lining of the intestine caused by weak points in the wall), polyps, hemorrhoids or cancer.

It is usually important to find the site of the bleeding. Common procedures used to localize the source of bleeding include "upper endoscopy" (looking into the esophagus and stomach using a fiberoptic scope inserted through the mouth) and "colonoscopy" (using a similar scope inserted through the rectum to look into the intestines). Sometimes, doctors perform studies with Barium (a harmless chemical that can be seen on X-rays) such as an "Upper GI Series" or a "Barium Enema" to help find the bleeding source.

Treatment of GI bleeding depends on the cause. Most important in patients with severe bleeding is to replenish lost blood with blood transfusions and to closely monitor blood counts. Ulcers and irritations of the lining of the GI tract can usually be treated with medications, while polyps and cancers frequently require surgery.

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