# Gastrointestinal Bleed --- A **gastrointestinal bleed** or a **GI bleed** is when there is some injury causing bleeding somewhere in the [[gastrointestinal tract]]. Location matters, the causes, signs and symptoms and treatment for a GI bleed depends on where exactly in the GI tract the bleed is. Determining the source of the bleed is a high priority for doctors to find out. GI bleeds can be largely divided into those in the upper GI and the lower GI tract. ## Upper GI Bleed An **upper GI bleed** is somewhere in the [[pharynx|throat]] and [[stomach]]. The causes are typically [[peptic ulcer disease|peptic ulcers]], [[esophageal varices]], or tumors. This could potentially lead to [[shock|hemorrhagic shock]]. The signs and symptoms of an upper GI bleed are: - vomit that is red or looks like coffee grounds - pallor - stomach cramps - lower Hgb/HCT - orthostatic BP - weakness Treatment of a upper GI bleed is to stop the bleeding and to treat the anemia/[[fluid volume deficit]]. They may need an NG tube or be put on NPO for GI rest and to reduce emesis. Goals of treatment: Stop bleeding- EGD (banding) Treat anemia/ fluid volume deficit- transfusion, IVF LR or NS May need NG tube NPO for Gl rest to reduce emesis ## Lower GI Bleed A **lower GI bleed** occurs somewhere in the duodenum and the [[intestines]]. The signs and symptoms of a lower GI bleed are: - melena (dark blood in stool) or bright red rectal bleeding Treatment for lower GI bleeds can include: - review health history and assess for causes - treat known causes - monitor for signs of hypovolemic shock - monitor HGB and HCT for decline - colonoscopy ___