The digestive tract has a rich blood supply as well as has a large internal surface area subjected to a lifetime of digestive actions. Partly as a result, this tract is subject to bleeding, including from conditions that can require care or in some cases can be dangerous. In particular, an arterial hemorrhage in the intestines or a ruptured ulcer in the stomach can cause signficant blood loss and sometimes require urgent intervention.
Gastrointestinal bleeding can occur anywhere in the digestive tract from the back of the mouth to the rectum, and is classified as upper or lower GI bleeding. Blood loss may be small and slow enough that it can only be detected by lab testing. Other times, it can can be quite evident, regurgitated in vomit or sputum or passed in stool, and can pose an emergency situation. Digestive tract bleeding can cause anemia if slower and longer term or dangerous drop in blood pressure if vigorous.
|No on should ever ignore GI bleeding. Often the cause is minor and passing, but not always. Lourdes’ GI service employs the full gamut of testing and can apply the most up-to-date interventions to locate and correct the cause of the problem.|
Determining Source, Severity and Course of Care
- inflammation of the esophagus or stomach;
- an enlarged vein or artery the ruptures;
- tears in the lining of the anus;
- inflammatory bowel disease.
Even if blood loss is slow, defining its cause is essential, and a careful medical history, physical exam, and assessment of other symptpms are important. The endoscopic specialists in Lourdes’ gastrenterology service have ample experience in identifying GI areas with potential to bleed as well as knowledge of how to proceed to identify the source of the problem when bleeding becomes evident. Capsule endoscopy, angiography and and a variety of other tests may also serve a roll in locating the site of bleeding. Most hemorrhages are minor and not dangerous, and will clot and heal on their own. Many can be treated medically, sometimes with drugs that constrict blood vessels to close off bleeding. But when blood loss is ongoing or too fast, the GI team may seek to close off the bleeding in a more expeditious fashion.
Minimally Invasive Intervention Successful for Most Patients
Once the Lourdes team finds the site of serious bleeding in the upper or lower GI tract that doesn’t stanch itself quickly or adequately enough, it can use state-of-the-science tissue-fusion technology to permanently occulude or fuse the involved tissue or vessels to halt the bleeding. A hemostatic tool, applied through the endoscope, uses radiofrequency energy to create a permanent seal in arteries, veins, lymph areas, or tissue bundles. Additional options to stop bleeding include laser cauterization or medicinal injection. On occasion, the team will involve an interventional radiologist to help locate a bleeding gut vessel and embolize it (inject particles into the blood vessel to block it).
Hospital care for gastrointestinal bleeding may include IV fluids or a blood transfusion. In some cases, the bleeding requires surgery, in which case Lourdes’ gastroenterologists work closely with general or colorectal surgeons to help supervise care.