Etiology of Upper and Lower Gastrointestinal Bleeding

Introduction

Gastrointestinal (GI) bleeding is a significant clinical concern that can originate from either the upper or lower GI tract. Timely diagnosis is essential to manage the condition effectively and prevent complications.

Etiology of GI Bleeding

Upper GI Bleeding

• Peptic Ulcers: Most common cause, associated with Helicobacter pylori infection and NSAID use.
• Esophageal Varices: Often seen in liver cirrhosis patients with portal hypertension.
• Gastritis: Inflammation of the stomach lining due to alcohol, NSAIDs, or infections.
• Mallory-Weiss Tears: Mucosal tears caused by severe vomiting or retching.

Lower GI Bleeding

• Diverticulosis: Painless bleeding from colonic diverticula.
• Hemorrhoids: Dilated veins in the anorectal region, leading to bright red blood per rectum.
• Inflammatory Bowel Disease: Includes ulcerative colitis and Crohn's disease.
• Colorectal Cancer: Chronic occult bleeding leading to iron deficiency anemia.

Diagnostic Approaches

To identify the source of GI bleeding, various diagnostic modalities are used:

• Endoscopy: Gold standard for direct visualization of lesions.
• Imaging Studies: CT angiography for active bleeding and radionuclide scanning.
• Laboratory Tests: Complete blood count (CBC), coagulation profile, and stool occult blood test.

Conclusion

Understanding the causes and diagnostic approaches for GI bleeding is critical for effective treatment. Early detection and management improve outcomes for affected patients.