The mouth is where the gastrointestinal (GI) tract starts, and it travels via the esophagus, stomach, small and large intestines, and rectum before coming to an end at the anus. Anywhere along this pathway, bleeding or hemorrhaging may be acute or chronic and caused by a variety of things.
The main signs are hematemesis (blood in the vomit) and/or melena (black stool, i.e., blood in stool). Epigastric and widespread abdominal discomfort, pale complexion, shortness of breath, and changes in consciousness are only a few of the possible accompanying symptoms.
Gastrointestinal bleeding is a sign of an illness rather than a sickness in and of itself. Upper and lower GI bleeding are two categories that apply to this hemorrhage. The oral cavity, esophagus, stomach, and the duodenum—the first segment of the small intestine—make up the upper GI tract. The jejunum, which is in the middle of the small intestine, and continuing to the anus make up the lower GI tract.
Esophageal varices, gastritis, peptic ulcers, inflammation, and malignancy are the main causes of upper GI bleeding. Diverticulitis (diverticular disease), infections, polyps, inflammatory bowel disease, hemorrhoids, anal fissures, and cancer are the most frequent medical diseases linked to lower GI bleeding.
Bleeds from the upper GI tract are significant causes of morbidity and mortality and are much more common than lower GI bleeds. Important to note is that mortality associated with upper GI bleeds are often as a result of comorbidities rather than the actual bleeding itself. Peptic ulcers are the most common cause of upper GI bleeding.
Peptic ulcer disease (PUD) accounts for up to 40% of cases and those at particularly high risk for PUD include alcoholics, patients on extensive NSAIDs, and those with chronic renal failure. PUD has been strongly linked to infection with Helicobacter pylori.
This bacterium is responsible for the destruction of protective mechanisms in the stomach and duodenum leading to damage by stomach acid that would otherwise not be a problem. These ulcers are found more commonly in the duodenum than in the stomach, although both locations present with equal incidences of bleeding.
