GI bleeding: Silent disease that can lead to cancer

Gastrointestinal (GI) bleeding, defined as a bleeding in any part of the gastrointestinal tract (digestive system) is a silent disease that can lead to cancer and become fatal but given proper attention and medical aid, life can be saved before it gets aggravated and help the patient lead a normal life, according to an expert in gastroenterology.

In western countries, it has been diagnosed that about 20 cases per 100,000 people have GI but the number of cases in Oman is steadily going high.

“Any significant bleeding into the lower GI tract, blood through the rectum, should be evaluated in the emergency department. Acute, large amount of bleeding is a dangerous situation as it most likely can lead to a shock and multi organ failure if no medical intervention done to patient on emergency basis”, said Dr Aamed, Consultant Colorectal Surgeon at Royal Hospital.

“Any presence of blood in the stool or from the upper gastrointestinal tract is significant and needs medical attention. Black or dark stools may represent slow bleeding from right sided colonic tumour and should be investigated and treated by a doctor”, Dr Aamed said adding that the most common causes and risk factors for lower GI bleeding include diverticular disease (diverticulosis), cancers, inflammatory bowel disease (crown’s disease and ulcerative colitis), infectious diarrhoea, angiodysplasia, polyps, haemorrhoids, and anal fissures.

Medically, Gastrointestinal (GI) bleeding is defined as a bleeding in any part of the gastrointestinal tract (digestive system). The GI tract includes esophagus (pipe from mouth to stomach), stomach, small intestine, colon, rectum, and anus. GI bleeding itself is not a disease, but an indication of many number of conditions. The causes and risk factors for gastrointestinal (GI) bleeding are classified into upper or lower, depending on their location in the GI tract.

“Having said, intermittent little amount of bleeding is not dangerous but need urgent medical attention to get a diagnosis and treat the cause. Sometimes it may be due to a cancer, which will need urgent surgical intervention”, the Doctor Aamed who is also a visiting consultant at Starcare Hospital said.

Acute gastrointestinal bleeding first will appear as bloody bowel movements. However, the major signs and symptoms of gastrointestinal (GI) bleeding include fatigue, weakness, shortness of breath (if significant or chronic), abdominal pain, and pale appearance (if significant or chronic).

Long-term GI bleeding may go unnoticed or may cause fatigue, anaemia, black stool, or a positive test for microscopic blood (especially with right sided colon cancer).

“For a specialist, the cause of gastrointestinal (GI) bleeding can be diagnosed by performing a complete history and physical exam to evaluate the patient’s problem. The doctor may include a digital rectal exam, to test for visible or microscopic blood from the rectum. Additionally, the lab tests such as complete blood count (CBC) and coagulation studies also can be helpful to determine the rate or severity of bleeding and to determine factors that may contribute to the problem. And colonoscopy on the patient will give a clearer picture of the incidence of bleeding”, Dr Aamed added.