Clinical Gastroenterology and Hepatology

GI Bleeding and Pathology

GI bleeding can originate anywhere from the mouth to the anus and can be overt or occult. The manifestations depend on the location and rate of bleeding.  Acute or chronic bleeding of internal haemorrhoids stops spontaneously in most cases. Patients with refractory bleeding are treated via anoscopy with rubber band ligation, injection, coagulation, or surgery. Massive GI bleeding is tolerated poorly by elderly patients. Diagnosis must be made quickly, and treatment must be started sooner than in younger patients, who can better tolerate repeated episodes of bleeding. Rectal bleeding may result from upper or lower GI bleeding. Orthostatic changes in vital signs are unreliable markers for serious bleeding. About 80% of patients stop bleeding spontaneously; various endoscopic techniques are usually the first choice for the remainder.