Upper GI Bleed (Bleeding from Stomach or Esophagus)
Bleeding from the upper gastrointestinal tract is not a problem of aging, but it is a common problem in elderly patients. The bleeding may come from any site from the nose to the upper portions of the small intestine. Most often the problem is from the stomach, caused by either ulcerations in the stomach wall or gastritis (inflammation of the wall of the stomach). Other possible sources are bleeding duodenal ulcers, bleeding esophageal varices, or arteriovenous malformations. Much less frequently, cancer of the stomach or esophagus, nosebleeds, or bleeding from the lung is the cause.
If the bleeding is rapid, one may vomit bright red blood or blood that looks like coffee grounds owing to exposure of the blood to acid in the stomach. Rapid bleeding may also stimulate rapid transport of the blood down the gastrointestinal tract so that it appears as red blood in the stool or as a black, tarry stool. During its stay in the digestive tract, blood turns black and sticky (tarry). If the bleeding is slow and the amounts are small, there may be no visible blood in the stool. Chemical testing is needed to detect its presence. This sort of blood is occult (hidden). Occasionally the bleeding is so slow and intermittent that anemia is the only finding.
When upper gastrointestinal tract bleeding occurs quickly enough and in visible amounts, it is an urgent problem to report to your physician. Do not neglect even slow bleeding, even though it is not an emergency. The goal is to find the bleeding source and to stop the bleeding without the need for transfusion or surgery, if possible. Generally the earlier that one can start treatment, the greater the likelihood that it will be successful.
Important Points in Treatment
Most bleeding from the gastrointestinal tract stops on its own. A search is undertaken by your physician for the cause of the bleeding to try to prevent future episodes. If the bleeding does not stop, techniques are available to the gastroenterologist or the radiologist to control the bleeding. If these are not successful, surgery may be needed, although resorting to surgery is uncommon.
Notify Our Office If ...
- You have any evidence of bleeding from the stomach. Blood in vomitus may be red but may also