Synonyms in a broader sense
GI bleeding; stomach bleeding, intestinal bleeding Medical: gastrointestinal bleeding, ulcer bleeding
Definition gastrointestinal bleeding
A gastrointestinal bleeding is a bleeding of the gastrointestinal tract that is visible from the outside. Blood is either vomited or excreted with the bowel movement, which can then lead to black or bloody bowel movements.
Frequency (Epidemiology)
Occurrence in GermanyIn Germany every year about 100 per 100,000 inhabitants are affected by gastrointestinal bleeding. An increasing proportion of these are in the over-60s. The stomach ulcer is typically located at the exit of the stomach. The picture below shows a cross-section of the stomach wall and shows how deep the stomach ulcer extends.
- Mucosa (mucous membrane)
- Ulcer (stomach ulcer)
- Submucosa (connective tissue layer)
- Blood vessels If the mucous membrane is damaged, this can extend into the underlying connective tissue, which can cause stomach bleeding.
Danger of death
While chronic gastric bleeding often goes unnoticed for a long period of time and is only noticed by chance (symptoms of anemia, typical blood count), acute gastric bleeding is often massive and life-threatening, with death occurring in 10-20% of cases. Gastric bleeding is always dangerous when injuries or openings of larger gastric vessels (A. gastrica) occur in the context of gastritis and peptic ulcers, as large quantities of blood can be lost in a relatively short time (a loss of 20% of normal blood volume is life-threatening). Furthermore, congenital vascular malformations in the stomach can cause major bleeding if the stomach is injured.
The so-called “Dieulafoy ulcer” is a rare, congenital disease in which a peptic ulcer can open a dilated vascular anomaly very close to the mucous membrane and lead to life-threatening bleeding. If gastric bleeding does not stop on its own or if there is a large loss of blood with shock symptoms due to acute blood deficiency in the circulatory system, rapid endoscopic or surgical hemostasis must be initiated. The administration of blood preservatives may also be necessary in cases of high blood loss.
