Bleeding can occur wherever there is tissue with blood supply, including in the gastrointestinal tract, which doctors then group together under the collective term gastrointestinal bleeding.
What is gastrointestinal bleeding?
The gastrointestinal tract is one of the most complex and largest organs in humans. The intestine alone is about ten meters long. Thus, there is ample surface area for gastrointestinal bleeding. The gastrointestinal tract is one of the most complex and largest organs in humans. The intestine alone has a length of about ten meters. Thus, there is enough surface area for gastrointestinal hemorrhage. What distinguishes gastrointestinal bleeding from ordinary bleeding or injuries of the (mucous) skin is the fact that the stomach with its gastric acid as well as the intestine with its intestinal flora consisting of a multitude of bacteria create a completely different environment, which makes the case of bleeding a bit more explosive. Once injuries to the gastric mucosa or the inner wall of the intestine occur, the germs living there can on the one hand unintentionally enter the bloodstream and on the other hand delay the healing of the injured area. Depending on the cause of gastrointestinal bleeding, doctors distinguish different types of bleeding.
Causes
Gastrointestinal bleeding is not a characteristic symptom of a single disease. Rather, a number of very different causes can be considered. For example, a mechanical injury to the gastrointestinal tract leading to the bleeding is possible, in that the affected person may have accidentally consumed a solid, pointed object over the meal. The mucosa of the small intestine in particular is especially thin and thus susceptible to injury of a mechanical nature. Another cause of gastrointestinal bleeding can be the presence of an underlying disease. Chronic intestinal inflammations such as Crohn’s disease or ulcerative colitis are conceivable here. People affected by these diseases suffer from a permanently inflamed intestine due to a permanent and misdirected reaction of their immune system. The lesions of the intestinal mucosa caused by the inflammation begin to bleed, ultimately resulting in the excretion of bloody stool. In the worst case, gastrointestinal bleeding can also be a sign of an existing carcinoma, i.e. a cancer (e.g. stomach cancer or colon cancer).
Diseases with this symptom
- Inflammation of the intestine (enteritis)
- Stomach cancer
- Reflux esophagitis
- Ulcerative colitis
- Colorectal cancer
- Mallory-Weiss syndrome
- Crohn’s disease
- Duodenal ulcer
- Esophageal varices
Typical symptoms and signs
- Nausea, possibly even vomiting blood (hematemesis).
- Stomach pain, abdominal pain and possibly abdominal pain.
- Feeling of fullness
- Blood in the stool or tarry stools
Diagnosis and course
What is the cause of gastrointestinal bleeding can not be determined from external observation of the gastrointestinal area. X-rays or the less stressful ultrasound here can not provide a reliable answer to the cause and especially extent of gastrointestinal bleeding. The detection of blood in the stool alone does not give any indication of the cause. It is therefore essential to examine the stomach and intestines from the inside using probes, which is done during a gastroscopy or colonoscopy. During this procedure, a probe is inserted into the mouth into the patient’s stomach or anally into the large intestine as well as the terminal small intestine (the last part of the intestine that connects to the large intestine). The probes are equipped with a video camera and surgical instruments that enable the attending physician not only to examine but also to take tissue samples. If tumor-like pieces of tissue are present, the physician can remove them and later have them examined histologically, i.e., by laboratory medicine, and thus locate the cause of the gastrointestinal bleeding.
Complications
Bleeding in the stomach or intestinal area is always a serious warning sign from the body. A medical checkup is essential even for seemingly small amounts of blood on the stool. Although pure mucosal inflammation, certain painkillers or harmless hemorrhoids can trigger bleeding, dangerous underlying diseases or tumors can also hide behind such symptoms.In the case of intensive, acute bleeding, such as from injured blood vessels or tears in the intestinal wall, the emergency service should be informed immediately. Vomited blood, conspicuous pain or black tarry stools also require rapid clarification of the cause. Often, symptoms of minor bleeding disappear on their own and there is no cause for concern. Unnoticed blood loss can reduce performance in the long term, lead to anemia or, in the worst case, death. Without treatment, affected individuals also risk developing ulcers, which often grow unnoticed for a long time and are only occasionally noticed by bleeding due to passing meals. Like all surgical procedures, treatment is subject to a certain basic risk. Nevertheless, the very widespread endoscopy for stomach and intestines is considered to be very well-tried. Occasionally, slight postoperative bleeding may occur due to tissue removal. Rarely, due to carelessness with the leading tube, the wall of the gastrointestinal tract is severely injured, resulting in emergency surgery. However, the risks of a purely control procedure for diagnosis are considered very low and can usually be performed on an outpatient basis without hospitalization.
When should you go to the doctor?
If symptoms of gastrointestinal bleeding occur, a trip to the doctor is advisable. This means that if a feeling of nausea or even vomiting blood, severe stomach pain and blood in the stool occur, a doctor should definitely be consulted. The doctor will first take an X-ray or use ultrasound to determine whether there is an injury in the gastrointestinal tract, which could be the cause of the bleeding. The doctor can also determine the extent of the bleeding in the gastrointestinal tract. If the patient has blood in the stool, examination of the gastrointestinal tract by means of a probe is usually unavoidable. In the course of such a gastroscopy or colonoscopy, polyps, among other things, can already be eliminated as a cause. In a gastroscopy, the doctor inserts the probe through the mouth, whereas in a colonoscopy, the probe is inserted anally. If a tumor is suspected as the cause, a tissue sample can also be taken by means of the probe, which is then examined in the laboratory to determine whether it is benign or malignant.
Treatment and therapy
How gastrointestinal bleeding must be treated depends on the specific cause. If a mechanical injury to the stomach or intestines was the cause of the bleeding, the wound will heal on its own, provided that the object causing the injury has been expelled. Already in the course of one day, the gastrointestinal mucosa renews several grams of tissue. This results in rapid healing of the injured area. The only possible treatment is the administration of anti-inflammatory substances or the recommendation to refrain from taking anticoagulant drugs in order to reduce blood loss. In the case of chronic inflammation of the intestines, on the other hand, the affected person must adhere to the general recommendations for his or her disease and, in the most extreme case, be fed via infusions. By bypassing the gastrointestinal tract, this should be spared until the chronic inflammation calms down and the gastrointestinal bleeding subsides. If necessary, immunosuppressants can be administered here to work against the cause of the inflammation and thus the bleeding: the patient’s own immune system. How to treat gastrointestinal bleeding thus cannot be said in general terms, but depends on the type of bleeding as well as the cause.
Outlook and prognosis
If mechanical injury is responsible for gastrointestinal bleeding, the subsequent course depends largely on the cause and extent of the injury. Swallowing smooth metallic objects usually results in only minor injuries that resolve quickly. The foreign body is excreted again naturally. In contrast, sharp and pointed objects as well as pieces of glass and broken glass are dangerous. Such foreign bodies can cause life-threatening internal injuries and require emergency surgery. If the causes of gastrointestinal bleeding are not known, the patient must expect to undergo extensive examinations. The gastrointestinal tract is then examined from the inside with probes during a colonoscopy. If pathological changes are detected, the physician will initiate appropriate therapies. In the case of gastric and intestinal ulcers, the chances of therapy are good.However, chronic diseases such as Crohn’s disease or ulcerative colitis are often the cause of the complaints. With chronic diseases, a cure is not always possible, but the doctor can alleviate the associated symptoms. However, gastrointestinal bleeding can also be a sign of cancer. Currently, the only method by which colorectal cancer can be cured is surgery. Other measures, such as chemotherapy or radiation, can only ensure the long-term success of treatment.
Prevention
Since gastrointestinal bleeding is not an independent disease, but is always associated with an underlying disease or injury to the gastrointestinal area, they can only be prevented by preventing other underlying diseases. Admittedly, some causes of gastrointestinal bleeding are unpredictable, especially those whose actual causes have not yet been medically proven, as is the case with Crohn’s disease, for example. However, a healthy diet rich in fiber and variety, as well as plenty of exercise and physical activity, will help to maintain a healthy gastrointestinal tract extraordinarily.
Here’s what you can do yourself
The cause of gastrointestinal bleeding should be medically clarified in any case, as well as whether the bleeding affects the stomach, intestines or possibly both areas of the body. The cause is usually inflammatory processes in the body. Self-help can be ruled out in the case of stomach bleeding. However, one’s own digestive process can be improved. Whether the stomach or the intestines are affected, both areas are involved in the digestive process. Therefore, if bleeding is present, irritating foods – too hot spices – and meals eaten too hot should be avoided. Similarly, alcohol fires up the inflammatory processes in the body. Eating portions that are too large also puts a strain on the stomach and intestines. It is usually recommended to eat several small meals spread throughout the day. It is beneficial for the digestive process to drink a glass of water about half an hour before meals and to abstain from drinks during the meal. In this way, the necessary gastric acid is not additionally diluted and the body is not stimulated to produce more of it. Furthermore, phases of movement and relaxation are beneficial. Movement stimulates the digestive system and the entire metabolism. Phases of relaxation – which can also be actively shaped by practicing techniques such as yoga or chi gong – reduce the cortisone content in the blood and increase the release of serotonin. The intake of micronutrients such as selenium also helps the body to slow down inflammatory processes. Alternative healing methods, such as Bach flower therapy, can also be tried against stress in everyday life.