Symptoms of Chronic Gastrointestinal Bleeding

Chronic gastrointestinal bleeding is bleeding that is usually slow and can either continue for a long time or start and stop in a short period of time.

The symptoms of chronic GI bleeding depend on where in the digestive tract the bleeding is occurring. Chronic bleeding in the GI tract may not be easily detected as acute GI tract bleeding because the signs of it are less obvious. It is important that you seek medical attention whenever you either see signs of GI bleeding, or show the symptoms of a GI bleed.

Chronic gastrointestinal bleeding can cause anemia in the patient. It is therefore important to know the symptoms of anemia. Those symptoms include:

• Fatigue, loss of energy
• Weakness
• Dizziness or lightheadedness
• Pale skin
• Shortness of breath, especially when exercising
• Difficulty concentrating
• Palpitations (feeling of the heart racing beating irregularly)
• Chest pain
• Cold hands and feet
• Headache

Your healthcare provider can order lab tests for anemia. The next steps would be to order a colonoscopy and an esophagogastroduodenoscopy to locate the source of the bleeding.

Bleeding in the digestive tract is not a disease, but rather a symptom of the disease. The cause of the bleeding may be related to a condition that can be cured, or it may be a symptom of a more serious condition.

The cause of the bleeding depends on where in the digestive tract the bleeding occurs.

Common Causes

In the Esophagus:

• Inflammation (esophagitis): Stomach acid that backs up into the esophagus can cause inflammation, and this inflammation may lead to bleeding.
• Varices: These are abnormally enlarged veins located at the lower end of the esophagus.
• Tears: A tear in the lining of the esophagus that is usually caused by prolonged vomiting, but may also be caused by prolonged coughing or hiccuping. This is sometimes called Mallory-Weiss syndrome, which is a disorder of the lower end of the esophagus caused by severe retching and vomiting and characterized by laceration associated with bleeding.
• Ulcers
• Cancer

In the Stomach:

• Ulcers: Ulcers may enlarge and erode through a blood vessel, causing bleeding.
• Gastritis
• Cancer

In the Small Intestine:

• Duodenal ulcer
• Inflammatory bowel disease: Inflammation may occur, which can lead to bleeding.
• Cancer

In the Large Intestine and Rectum:

• Hemorrhoids: This is the most common cause of visible blood in the lower digestive tract, and is usually a bright red. They are enlarged veins in the anal area that can rupture and bleed.
• Ulcerative colitis: Inflammation and small ulcerations can cause bleeding.
• Crohn's disease: This is a chronic condition that can cause inflammation that may result in rectal bleeding.
• Colorectal cancer: This is a condition caused by out-pouching of the colon wall.

Treatment

Treatment of bleeding in the digestive tract depends on the cause of bleeding, and whether the bleeding is acute or chronic. For example, if aspirin is responsible for the bleeding, a patient stops taking aspirin and the bleeding is treated. If cancer is the cause of the bleeding, the usual course of treatment is the removal of the tumor. If a peptic ulcer is the cause of the bleeding, the healthcare provider may prescribe a drug for the treatment of H. pylori, recommend a change in diet, possibly a change in lifestyle.

The first step in the treatment of GI bleeding is to stop the bleeding. This is usually done by injecting chemicals directly into a bleeding site, or by cauterizing the bleeding site with a heater probe passed through an endoscope.

The next step is to treat the condition that caused the bleeding. This includes medications used to treat ulcers, esophagitis, H. pylori, and other infections. These include proton pump inhibitors (PPIs), H2 blockers, and antibiotics. Surgical intervention may also be needed, especially if the cause of the bleeding is a tumor or polyps, or if treatment with an endoscope is unsuccessful.