Other diagnostic methods for detecting a bleeding source might include a nuclear bleeding scan, angiography, or barium GI studies. In a colonoscopy, a video colonoscope is passed through the rectum and across the entire colon, while the patient is sedated. If the bleeding is suspected to be in the lower GI tract or colon, then a colonoscopy is usually performed. For example, a bleeding ulcer may be controlled with use of cautery, laser photo therapy, injection therapy or tamponade. If a site is detected, therapeutic measures can be used to control the bleeding. It allows the doctor to examine the esophagus, stomach and duodenum for any potential bleeding sites. This is a flexible video endoscope that is passed through the mouth and into the stomach while the patient is sedated. If it is suspected that the bleeding is in the upper gastrointestinal tract, then an upper GI endoscopy is usually the first step. Conditions like rectal cancer, polyps, ulcerations, proctitis or infections can also cause this type of bright red blood. This is frequently due to hemorrhoids however, you should never assume rectal bleeding is due to hemorrhoids. Hematochezia, or bright red blood can be mixed in with the stool or after the bowel movement and usually signifies a bleeding source close to the rectal opening. Other causes of a black stool might include iron or ingestion of bismuth (Pepto-Bismol). A black, tarry stool (melena) often indicates an upper GI source of bleeding although it could originate from the small intestine or right colon. More obvious bleeding may present with hematemesis (bloody vomit), which may either be red or dark and coffee-like in appearance.īlood in the stool could either be bright red, burgundy and clotted, or black and tarry in appearance, depending on the location of the bleeding source. In more severe cases of chronic or acute bleeding, symptoms may include signs of anemia, such as weakness, pallor, dizziness, shortness of breath or angina. Blood in the stool often can be detected by hemoccult testing (testing for blood in your stool) during a routine office examination. Many of these patients never notice any blood loss, but it occurs in small amounts with the bowel movement so that it is not noticeable. Mild, chronic GI blood loss may not show any active bleeding, but can still result in an iron deficiency anemia. The symptoms of GI bleeding depend on the acuteness and on the source of the blood loss. Also, making an accurate diagnosis can allow a patient to be treated appropriately for the underlying condition that caused the bleeding in the first place. An exact diagnosis may prevent a recurrence of bleeding and may help us treat future episodes more effectively. Many bleeding episodes resolve on their own, but it is still imperative that the bleeding site be determined. The overall mortality for severe GI bleeding is approximately 8 percent, but this number is diminishing with the arrival of superior diagnostic techniques and newer medical treatments. It can vary in degrees, from massive life-threatening hemorrhage to a slow, insidious chronic blood loss. Gastrointestinal (GI) bleeding is a common clinical problem frequently requiring hospitalization.
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