What is Gastrointestinal Bleeding?


Gastrointestinal bleeding can occur in the upper or lower gastrointestinal tract. There can be several causes.

Upper GI bleeding

Causes can include:

Peptic ulcer. This is the most common cause of upper GI bleeding. Peptic ulcers are sores that develop on the lining of the stomach and upper part of the small intestine. A specific bacterium called Helicobacter Pylori or use of anti- inflammatory drugs like aspirin, ibuprofen, and others damage the lining leading to formation of ulcers.

Tears in the lining of the esophagus. Known as Mallory-Weiss tears can cause bleeding.

Esophageal Varices. These are abnormal veins in the esophagus. This often occurs in patients with advanced liver disease.

Lower GI bleeding

Causes can include:

Cancers. Colon cancer can weaken the lining of the colon causing bleeding.

Colon polyps. Polyps are small clumps of cells that form on the lining of your colon and can cause bleeding. Most are harmless but some might become cancerous if not removed.

Hemorrhoids. These are swollen veins in your lower rectum or anus.

Anal fissure. These are small tears in the lining of the anus.

Diverticular disease. This involves the formation of bulging pouches in the colon.

Inflammatory bowel disease. This includes ulcerative colitis and Crohn’s disease.


Signs and symptoms of GI bleeding can be either obvious (overt) or hidden (occult)

Overt bleeding may present as:

  • Bright red blood coating the stool.
  • Dark stool mixed with stool.
  • Black or tarry stool.
  • Bright red blood in vomit
  • Coffee ground appearance of vomit.

Hidden blood in the stool may present as:

  • Your doctor may find blood in the stool by a quick test in the office.
  • Anemia (low blood counts)