Stomach Bleeding

Stomach bleeding is a critical symptom rather than a disease itself, pointing to an underlying problem in the digestive system. It occurs when blood leaks from the gastrointestinal tract, particularly the stomach or the upper intestines. Sometimes, the bleeding is visible in vomit or stool, while in other cases, it may be hidden and detected only through tests.

Mild stomach bleeding may resolve on its own, but persistent or heavy bleeding requires immediate medical attention. It is a common symptom of ulcers, gastritis, oesophageal varices, or even malignancies. Understanding its causes and symptoms is essential for early detection and treatment.

Stomach bleeding refers to the loss of blood from the tissues of the stomach lining, often as a result of inflammation, erosion, ulcers, or tears. This condition may present as haematemesis (vomiting blood), melena (black, tarry stools), or occult bleeding (hidden and detectable only via lab tests).

Stomach bleeding is classified as upper gastrointestinal (GI) bleeding, as it typically originates from the oesophagus, stomach, or the duodenum. It can lead to anaemia, fatigue, and in severe cases, haemorrhagic shock.

Gastrointestinal bleeding is a global health concern. In India, peptic ulcers are a leading cause of upper GI bleeding, particularly in rural areas with high Helicobacter pylori infection rates and rampant NSAID use. It is more prevalent among older adults and males.

Globally, the incidence of upper GI bleeding ranges between 40 to 150 per 100,000 people annually. Hospitalisations due to this condition are common, especially in developed nations.

Stomach bleeding can be categorised into several types depending on the location and presentation:

• Overt bleeding: Clearly visible signs such as vomiting blood or black, tarry stools.
• Occult bleeding: Hidden bleeding not seen visually but detected via stool tests.
• Chronic bleeding: Continuous, slow bleeding causing iron-deficiency anaemia.
• Acute bleeding: Sudden and heavy blood loss requiring emergency care.

Several conditions can lead to bleeding in the stomach, including:

• Peptic Ulcers: Most common cause; ulcers formed due to Helicobacter pylori infection or NSAID usage.
• Gastritis: Inflammation of the stomach lining caused by alcohol, smoking, infections, or prolonged NSAID use.
• Oesophageal Varices: Swollen veins in the oesophagus due to liver disease can burst and bleed.
• Gastrointestinal Cancers: Stomach, oesophageal, or duodenal cancers may cause bleeding.
• Mallory-Weiss Tears: Tears in the oesophagus lining due to forceful vomiting.
• Use of Blood Thinners: Medications like aspirin, warfarin, or clopidogrel increase bleeding risk.
• Stress Ulcers: Occur during severe illness or post-surgery.
   

Signs may vary depending on the severity and cause but typically include:

• Vomiting blood (bright red or dark resembling coffee grounds)
• Black, tarry stools (melena)
• Bright red blood in stools
• Abdominal pain or cramps
• Fatigue or weakness
• Dizziness or fainting (especially after standing up)
• Pale skin
• Rapid heartbeat or breathing
• Signs of shock in severe cases

Proper diagnosis is crucial and involves:

• Medical History and Examination: To identify underlying conditions and medications.
• Stool Test (Guaiac Test): To detect hidden blood.
• Complete Blood Count (CBC): To assess haemoglobin levels.
• Endoscopy: Direct visualisation of the stomach and upper GI tract.
• CT Scan or Abdominal Ultrasound: To rule out tumours, ulcers, or other abnormalities.
• Angiography: Used in cases of active, uncontrollable bleeding to find and block the source.

Treatment depends on the cause and severity:

• Hospital Admission: For moderate to severe bleeding.
• IV Fluids and Blood Transfusions: To stabilise the patient. (NS Infusion 100mg)
• Endoscopic Therapy: Involves cauterisation, clipping, or injection to stop the bleed.
• Medications:
  
  • Proton pump inhibitors (PPIs) to reduce acid and promote healing. (Esolax 40mg injection)
  • Antibiotics for Helicobacter pylori
  • Anti-bleeding drugs (like octreotide) for variceal bleeding
  • Avoidance of NSAIDs and anticoagulants if responsible
• Surgery: In extreme cases where endoscopy fails
• Embolisation: Interventional radiology to block bleeding vessels
   

While not primary treatments, some supportive therapies include:

• Herbal Teas: Like chamomile or liquorice root (anti-inflammatory)
• Probiotics: To maintain gut flora, especially after antibiotic therapy
• Acupuncture: May help reduce nausea but not bleeding itself
• Nutritional Support: Iron-rich diet post-recovery

Note: Always consult your doctor before trying any alternative remedy.

• Long-term NSAID or aspirin use
• Chronic alcohol consumption
• Smoking
• Older age
• Helicobacter pylori infection
• Liver disease
• Stress and critical illness
• History of gastrointestinal disorders
• Use of blood thinners or steroids

Untreated stomach bleeding can result in:

• Severe blood loss and anaemia
• Hypovolemic shock
• Death in extreme cases
• Perforation of stomach wall
• Secondary infections
• Reduced oxygen delivery to vital organs
• Recurrent bleeding

• Take prescribed medications regularly
• Avoid alcohol and tobacco
• Eat soft, non-irritating foods during recovery
• Stay hydrated and eat iron-rich foods (spinach, lentils, red meat)
• Monitor stool colour and frequency
• Keep follow-up appointments
• Report any recurrence of symptoms immediately

• Myth: All blood in vomit is from the stomach.
  
  • Fact: It could originate from the oesophagus or even lungs.
• Myth: Black stools always indicate stomach cancer
  
  • Fact: They often result from bleeding ulcers.
• Myth: Over-the-counter antacids can treat all bleeding issues.
• Fact: Antacids provide temporary relief but do not address underlying causes.
   

• Vomiting blood or passing black stools
• Feeling faint, dizzy, or light-headed
• Rapid heartbeat or shallow breathing
• Unexplained weight loss or fatigue
• Persistent stomach pain
• Chronic use of NSAIDs or blood thinners
   

• What is causing my stomach bleeding?
• Do I need an endoscopy?
• What are the treatment options?
• Is this condition likely to recur?
• Can I continue my current medications?
• How can I prevent future episodes?

• Stay calm and provide reassurance
• Help them lie down in a comfortable position
• Avoid giving them food or water during active bleeding
• Record the amount and appearance of vomit/stool
• Seek emergency medical help if symptoms are severe
• Offer emotional support during hospital visits and recovery
   

Stomach bleeding is a potentially serious symptom that should never be ignored. Whether caused by ulcers, infections, or medications, early diagnosis and treatment can significantly reduce risks and improve recovery outcomes. Lifestyle changes, medication adherence, and regular monitoring are essential for long-term health.