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Gastrointestinal Bleeding

  • Cynthia M. Johnson, MA
Publication Type:


Gastrointestinal Bleeding

(GI Bleeding)


Gastrointestinal (GI) bleeding is bleeding in the digestive tract. It can range from mild to severe and can be life-threatening.

Digestive Track.

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The upper digestive tract is the:

  • Esophagus—the tube that moves food from the mouth to the stomach
  • Stomach
  • Upper part of the small intestine

The lower digestive tract is the:

  • Lower part of the small intestine
  • Large intestine
  • Rectum and anus


GI bleeding has many causes.

Causes in the upper digestive tract may be:

  • Peptic ulcer—a sore in the lining of the stomach or part of the small intestine
  • Esophageal varices—swollen veins in the esophageal lining
  • Mallory-Weiss tears—tears in the esophageal lining
  • Gastritis—inflammation and sores in the stomach lining
  • Esophagitis—inflammation and sores in the esophageal lining
  • Benign tumors—noncancerous growths
  • Stomach arteriovenous malformations
  • Cancer in the esophagus, stomach, or small intestine

Causes in the lower digestive tract:

Risk Factors

Things that may raise the risk of GI bleeding are:

  • Having bleeding problems
  • Alcohol use disorder
  • Long-term use of steroids, blood thinners, nonsteroidal anti-inflammatory drugs (NSAIDs), or aspirin
  • Smoking
  • Previous GI or vascular surgery
  • Past GI disease or bleeding
  • A history of ulcers
  • Past infections, such as Helicobacter pylori


Upper and lower GI bleeding may cause:

  • Black, tarry stool (poop)
  • Blood in the stool

Upper digestive tract bleeding may also cause:

  • Blood in vomit
  • Vomit that looks like coffee grounds

Sometimes, bleeding can happen quickly and be severe. This may cause:

  • Weakness
  • Light-headedness or faintness
  • Breathing problems
  • Belly pain
  • Loose stools
  • Pale skin

Bleeding may be light and happen for a long time. This may cause a person to be tired and have problems breathing.


The doctor will ask about symptoms and past health.

Tests that may be done are:

  • Blood tests
  • Breath test
  • Stool test to check for blood
  • Upper GI endoscopy—a thin, lighted tube is placed in the mouth and moved into the stomach and upper small intestine
  • Colonoscopy—a thin, lighted tube is placed in the anus and moved into the rectum and large intestine
  • Computed tomography (CT) scan
  • Barium x-ray—contrast material is swallowed or used as an enema to see structures
  • Radionuclide scanning—to see how blood flows through the GI tract
  • Angiography—to see the blood vessels
  • A nasogastric tube placed through the nose and into the stomach


Treatment depends on what is causing the bleeding. Options may be:

  • Stopping or changing certain medicines
  • Medicines to treat the cause, such as:
    • Lower the amount of acid the stomach makes
    • Treat bacterial infections
    • Lessen bleeding
    • Lessen inflammation
    • Place healthy bacteria into the GI tract

Endoscopy can also be used to stop bleeding. This may be done by:

  • Injecting chemicals into the bleeding site
  • Using a heat probe, electric current, or laser—to seal off the bleeding site
  • Using a band or clip to close off blood vessels

Angiography can also be used to control bleeding. Other tools are used to find the bleeding. Medicines or other materials are injected into the blood vessels to control it.

Surgery may be used when other methods fail. It may be needed to treat problems, such as uncontrolled bleeding.


To lower the risk of GI bleeding:

  • Limit alcohol use.
  • Use NSAIDs only as advised.
  • Do not smoke.




  • Acute lower gastrointestinal bleeding in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-lower-gastrointestinal-bleeding-in-adults.
  • Acute nonvariceal upper gastrointestinal bleeding. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/acute-nonvariceal-upper-gastrointestinal-bleeding.
  • Barkun AN, Almadi M, et al. Management of nonvariceal upper gastrointestinal bleeding: guideline recommendations from the International Consensus Group. Ann Intern Med. 2019;171(11):805-822.
  • Gastrointestinal (GI) bleeding. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/gastrointestinal-bleeding.
  • Overview of gastrointestinal bleeding. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/gastrointestinal-bleeding/overview-of-gastrointestinal-bleeding.


  • Daniel A. Ostrovsky, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.