Approach to acute upper gastrointestinal bleeding in adults. Approach to acute lower gastrointestinal bleeding in adults. National Institute of Diabetes and Digestive and Kidney Diseases. ACG clinical guidelines: Management of patients with acute lower gastrointestinal bleeding. Overview of gastrointestinal bleeding.New York, N.Y.: The McGraw-Hill Companies 2018. In: Harrison's Principles of Internal Medicine. If you have GERD, follow your doctor's instructions for treating it.Limit your use of nonsteroidal anti-inflammatory drugs.Inflammation of the lining of the rectum can cause rectal bleeding. These are small tears in the lining of the anus. These are swollen veins in your anus or lower rectum, similar to varicose veins. Most are harmless, but some might be cancerous or can become cancerous if not removed. Small clumps of cells that form on the lining of your colon can cause bleeding. Noncanerous (benign) or cancerous tumors of the esophagus, stomach, colon or rectum can weaken the lining of the digestive tract and cause bleeding. This includes ulcerative colitis, which causes inflammation and sores in the colon and rectum, and Crohn's disease, and inflammation of the lining of the digestive tract. If one or more of the pouches become inflamed or infected, it's called diverticulitis. This involves the development of small, bulging pouches in the digestive tract (diverticulosis). This inflammation of the esophagus is most commonly caused by gastroesophageal reflux disease (GERD). This condition occurs most often in people with serious liver disease. Abnormal, enlarged veins in the esophagus (esophageal varices).These are most common in people who drink alcohol to excess. Known as Mallory-Weiss tears, they can cause a lot of bleeding. Tears in the lining of the tube that connects your throat to your stomach (esophagus).Stomach acid, either from bacteria or use of anti-inflammatory drugs, damages the lining, leading to formation of sores. Peptic ulcers are sores that develop on the lining of the stomach and upper portion of the small intestine. This is the most common cause of upper GI bleeding. Gastrointestinal bleeding can occur either in the upper or lower gastrointestinal tract. Internal hemorrhoids are usually painless, but they tend to bleed. Hemorrhoids are swollen veins in the lower rectum. For other indications of GI bleeding, make an appointment with your doctor. If you're vomiting blood, see blood in your stools or have black, tarry stools, seek immediate medical care. If you have symptoms of shock, you or someone else should call 911 or your local emergency medical number. Not urinating or urinating infrequently, in small amounts.If your bleeding starts abruptly and progresses rapidly, you could go into shock. Rectal bleeding, usually in or with stool.Vomiting blood, which might be red or might be dark brown and resemble coffee grounds in texture. Signs and symptoms depend on the location of the bleed, which can be anywhere on the GI tract, from where it starts - the mouth - to where it ends - the anus - and the rate of bleeding. Signs and symptoms of GI bleeding can be either obvious (overt) or hidden (occult).
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