GI Bleeding

About GI Bleeding

Gastrointestinal bleeding is a common medical emergency characterized by blood loss from any part of the digestive tract, from the mouth to the anus. It is classified as upper GI bleeding (above the ligament of Treitz) or lower GI bleeding (below the ligament of Treitz), with different etiologies and management approaches for each location.

Pathophysiology

Upper GI bleeding commonly results from peptic ulcers, esophageal varices, or Mallory-Weiss tears, while lower GI bleeding typically stems from diverticulosis, hemorrhoids, or colorectal malignancy. The bleeding occurs when mucosal integrity is compromised by inflammation, increased pressure, trauma, or neoplastic processes, leading to erosion of blood vessels within the GI tract wall.

Clinical Reasoning

Diagnosis requires careful assessment of bleeding location through clinical presentation (hematemesis suggests upper GI, hematochezia typically indicates lower GI), vital signs for hemodynamic stability, and appropriate endoscopic evaluation. Management priorities include hemodynamic stabilization, identification of bleeding source, and targeted therapy ranging from conservative measures to endoscopic intervention or surgical repair depending on severity and underlying cause.