Internal stomach bleeding, often referred to as gastrointestinal (GI) bleeding, occurs when there is blood loss from any part of the digestive tract. Internal stomach bleeding is a serious medical issue that always requires prompt medical evaluation and attention.
Recognizing the Signs
Detecting internal stomach bleeding often relies on recognizing specific physical signs and changes in bodily functions. Vomiting blood, medically known as hematemesis, can present as bright red blood, streaks of blood mixed with food, or a dark, granular substance resembling coffee grounds. Bright red blood in vomit typically indicates active, fresh bleeding higher up in the digestive system, such as the esophagus or stomach. Conversely, vomit that looks like coffee grounds suggests older blood that has been exposed to stomach acid, causing the iron in hemoglobin to oxidize and change color and texture. This distinctive appearance usually signals bleeding in the upper GI tract, including the esophagus, stomach, or the first part of the small intestine.
Changes in stool appearance also provide important clues about internal bleeding. Black, tarry, and foul-smelling stools, known as melena, typically result from bleeding in the upper GI tract. The dark color and sticky consistency occur because the blood has traveled through the digestive system, where digestive chemicals and bacteria alter its hemoglobin. In contrast, bright red blood in the stool, called hematochezia, usually indicates bleeding from the lower GI tract, such as the colon, rectum, or anus. However, very rapid bleeding from the upper GI tract can also appear as bright red blood in stool, as it passes through the system quickly.
Beyond these overt signs, internal bleeding can manifest through more subtle symptoms related to blood loss. Individuals may experience fatigue, weakness, or dizziness, which can be signs of anemia resulting from ongoing blood loss. Rapid or weak heartbeat, pale skin, and lightheadedness are also common as the body tries to compensate for reduced blood volume. Abdominal pain, nausea, and a reduced desire to eat can accompany bleeding, depending on its cause and location.
When to Seek Medical Attention
Any suspicion of internal stomach bleeding warrants prompt medical evaluation. This is because internal bleeding can be a symptom of various underlying medical conditions, some of which require immediate intervention.
Certain signs necessitate immediate emergency care. You should call emergency services or go to the nearest emergency room if you vomit large amounts of blood, or if your vomit resembles coffee grounds. Similarly, passing large amounts of blood in your stool, especially if it is black and tarry or bright red and heavy, is a medical emergency. Accompanying symptoms such as fainting, severe abdominal pain, chest pain, or signs of shock like cold, clammy skin, a rapid pulse, or very low blood pressure also indicate a critical situation. These symptoms suggest significant blood loss that can quickly become life-threatening.
Medical Diagnostic Approaches
Healthcare professionals employ several diagnostic approaches to pinpoint the source and severity of internal stomach bleeding. Initial steps often include a physical examination, a review of symptoms, and laboratory blood tests. Blood tests, such as a complete blood count, can reveal signs of blood loss like anemia, indicating how severe the bleeding might be. Stool tests, specifically the fecal occult blood test, can detect microscopic amounts of blood not visible to the naked eye.
Endoscopic procedures are commonly used to visualize the digestive tract directly. An upper endoscopy involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and the first part of the small intestine. This procedure can identify the bleeding source, and sometimes allow for immediate treatment to stop the bleeding. For suspected bleeding in the lower GI tract, a colonoscopy is performed, where a similar scope is inserted into the rectum to view the entire large intestine.
When the source of bleeding is not found with standard endoscopy, a capsule endoscopy may be utilized. This non-invasive procedure involves swallowing a vitamin-sized capsule containing a tiny camera that takes thousands of pictures as it travels through the entire digestive tract. These images are transmitted to a recorder worn by the patient, helping identify issues in areas difficult to reach with traditional scopes.
Imaging tests also play a role in diagnosis. Computed tomography (CT) scans, including CT angiography, can provide detailed views of the abdomen and pelvis, helping to locate the bleeding source. CT angiography is a rapid and widely available test that can identify the precise location of active bleeding, guiding further management. In some cases, a procedure called angiography can also help identify and treat bleeding vessels.