Internal bleeding, also known as hemorrhage, occurs when blood escapes from damaged blood vessels and collects inside the body rather than exiting through an external wound. It is possible to experience internal bleeding without immediately realizing it. This condition can vary significantly in severity, ranging from minor, self-resolving bleeds to life-threatening emergencies that require immediate medical intervention.
Why Internal Bleeding Can Go Undetected
Internal bleeding can remain unnoticed for several reasons. Often, bleeding occurs deep within tissues or body cavities, such as the abdomen or chest, where blood does not have an obvious exit point. This makes it difficult to observe any outward signs of blood loss, unlike external cuts or wounds.
Some internal bleeding develops gradually, allowing the body to compensate for blood loss without showing overt symptoms. The body’s compensatory mechanisms, like increasing heart rate to maintain blood pressure, can mask the early signs. Initial symptoms can also be non-specific, such as general weakness, fatigue, or dizziness, which may be attributed to minor ailments or stress.
Common Causes of Internal Bleeding
Trauma is a frequent cause of internal bleeding, resulting from incidents like vehicle accidents, falls, or direct blows to the body. This can involve blunt force injuries, where blood vessels are torn or crushed, or penetrating trauma, where an object pierces the body. Fractures, particularly of large bones such as the thigh bone or pelvis, can also cause significant blood loss if bone fragments damage surrounding vessels.
Medical conditions also cause internal bleeding. Gastrointestinal issues like peptic ulcers, gastritis, Crohn’s disease, or diverticulosis can cause bleeding within the digestive tract. Aneurysms, weakened areas in artery walls, pose a risk of severe bleeding if they rupture, commonly occurring in the brain or aorta. Certain cancers can lead to internal bleeding if tumor cells invade blood vessels or organs. Conditions specific to females, such as a ruptured ovarian cyst or ectopic pregnancy, can also cause internal bleeding.
Complications from medical procedures and certain medications contribute to internal bleeding. Bleeding may occur following surgery or other invasive medical procedures. Medications, especially blood thinners (anticoagulants) and antiplatelet drugs, increase bleeding risk by interfering with clotting. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin can irritate the stomach lining and cause gastrointestinal bleeding.
Recognizing the Signs
Recognizing the signs of internal bleeding is important for seeking timely care. General symptoms include unexplained fatigue, weakness, dizziness, or lightheadedness due to decreased blood volume. Individuals may also experience pale skin, shortness of breath, a rapid heart rate, low blood pressure, nausea, vomiting, and excessive thirst.
Localized signs provide clues about the bleeding area. Pain, swelling, and bruising may appear at an injury site. For instance, abdominal tenderness or rigidity could indicate bleeding within the abdominal cavity. Swelling and pain in muscles or joints, especially after trauma, can point to internal bleeding in those areas.
Specific signs depend on the bleeding location. Head bleeding might manifest as a severe, sudden headache, vision changes, confusion, or weakness or numbness on one side of the body. Chest bleeding can cause difficulty breathing, chest pain, or coughing up blood. In the digestive tract, signs include vomiting blood (bright red or “coffee grounds”) or blood in the stool (black and tarry melena or bright red hematochezia). Blood in the urine (hematuria), making it pink, red, or brown, suggests bleeding in the urinary tract.
If significant blood is lost, signs of shock may develop. These include a rapid heart rate, low blood pressure, cool and clammy skin, confusion, and changes in alertness. Shallow, rapid breathing and a weak pulse indicate the body is struggling to cope with blood loss.
When to Seek Immediate Medical Help
Internal bleeding is a medical emergency that requires prompt attention. Seek immediate medical evaluation if internal bleeding is suspected, particularly after a traumatic event.
Specific symptoms warranting an emergency room visit or calling emergency services include severe pain after an injury or any signs of shock. Significant changes in consciousness, persistent or worsening general symptoms like dizziness or weakness, or observing blood in bodily fluids such as vomit, urine, or stool, also require urgent medical care. Early detection and treatment are crucial.