Gastrointestinal (GI) bleeding 

Diagnosis  

During your medical assessment, your physician will gather your medical history, including any previous incidents of bleeding. They will also conduct a physical examination and may recommend various diagnostic procedures. These tests include: 

• Blood Tests: These may involve a complete blood count, clotting speed assessment, platelet count, and liver function evaluations. 
• Fecal Occult Blood Test (FOBT): This laboratory test checks for indications of blood in a stool sample. 
• Nasogastric Lavage: This involves passing a tube through your nose into your stomach to remove stomach contents, aiding in identifying the source of the bleed. 
• Gastrointestinal (GI) X–rays: These images focus on your upper or lower digestive tract, using a barium contrast solution to enhance visibility on X–rays. 
• Computed Tomography (CT) Scan: This advanced imaging technique generates 3D enhanced views of your intestines. Upper Endoscopy: Using a small camera attached to a long tube, your doctor examines your upper gastrointestinal tract by inserting the tube through your mouth. 
• Colonoscopy: Similar to upper endoscopy, this procedure employs a camera–fitted tube inserted through your rectum to visualize your large intestine and rectum. 
• Flexible Sigmoidoscopy: This procedure involves inserting a tube equipped with a light and camera into your rectum to visualize your rectum and the adjacent part of your large intestine, known as the sigmoid colon. 
• Capsule Endoscopy: You’ll swallow a capsule with a tiny internal camera. As the capsule travels through your digestive tract, it captures numerous pictures relayed to a recording device worn around your waist. This provides valuable insights into your small intestine. 
• Balloon Enteroscopy: Similar to an endoscopy, this technique uses long tubes and a camera. Small balloons on the endoscope inflate to aid in examining the challenging–to–reach small bowel. 
• Angiography: This involves injecting a contrast dye into an artery, followed by a series of X–rays to locate and address bleeding vessels or anomalies. 
• Radionuclide Scan: This scan entails receiving a substance with a safe level of radioactive material. The substance highlights red blood cells during an imaging procedure.  

Treatment   

Frequently, gastrointestinal (GI) bleeding can resolve on its own. If it persists, treatment varies depending on the underlying cause. During diagnostic tests, interventions like medications or procedures can often be administered. For example, bleeding from a peptic ulcer might be addressed using medication or a procedure conducted during an upper endoscopy. Similarly, colon polyps could be removed during a colonoscopy.  

In cases of upper GI bleeding, an IV–administered proton pump inhibitor (PPI) can help reduce stomach acid production. After identifying the source of bleeding, your doctor will determine the necessity of ongoing PPI usage. Depending on the extent of blood loss and the continuation of bleeding, intravenous fluids and blood transfusions may be required. If you are taking blood–thinning medications such as aspirin or nonsteroidal anti–inflammatory drugs, discontinuing them might be necessary.