Gastrointestinal Bleeding

Definition

  • Intraluminal blood loss anywhere from the oropharynx to the anus
  • Classification: upper = above the ligament of Treitz; lower = below the ligament of Treitz
  • “Severe” GIB: defined as having associated shock, orthostatic hypotension, ↓ Hct by 6% (or ↓ Hb by 2 g/dL), or requiring transfusion ≥2U PRBCs. Requires hospitalization.

Clinical manifestations

  • Hematemesis = blood in vomitus (UGIB)
  • Coffee-ground emesis = emesis of blood exposed to gastric acid (UGIB)
  • Melena = black, tarry stools from digested blood (usually UGIB, but can be from R colon)
  • Hematochezia = bloody or n-colored stools (LGIB or rapid UGIB)