Symptoms
Chronic GI bleeding, meaning the bleeding is slow, persistent or keeps recurring, tends to have less obvious symptoms, since it may come out in vomit or stool in microscopic amounts. However, chronic bleeding can lead to anemia, which is when you have fewer red blood cells than you should. Symptoms of anemia include:
FatigueShortness of breathWeaknessPale skinFeeling lightheaded or dizzyChest painHeadachesCold hands and feetHeart palpitationsDifficulty concentrating
If you do see blood in your vomit or stool, notice black, tarry stools, or vomit what looks like coffee grounds, you should see your healthcare provider as soon as possible.
Acute GI bleeding is severe and possibly sudden. If you have these symptoms, you need to seek emergency medical care:
Shortness of breathWeaknessBlood in your stoolBlood in your vomitVomit that looks like coffee groundsFatigueFeeling lightheaded or dizzyConfusionDisorientationDiarrheaSleepiness
Acute bleeding can send you into shock. Symptoms of shock include:
Rapid pulseBlood pressure dropUnconsciousnessNot urinating often or at all
Causes
There are different causes of bleeding in the esophagus, depending on whether your bleeding is chronic or acute.
Causes of chronic bleeding include:
Inflammation (esophagitis): Stomach acid that backs up into your esophagus can cause inflammation, and this inflammation may lead to bleeding. If it’s left untreated or goes on too long, you may vomit blood or a substance that looks like coffee grounds, which is an emergency situation. Esophageal cancer: There are two types of esophageal cancer. Most of the length of the esophagus is lined with squamous cells, so if a malignant tumor grows here, it’s called squamous cell cancer. The areas at the bottom of the esophagus, and where the esophagus joins the stomach, are lined with columnar cells. If a malignant tumor grows here, it’s called adenocarcinomas. Ulcers: An ulcer can form in your esophagus if stomach acid increases or the mucous layer that coats the lining of your digestive tract decreases. Causes of esophageal ulcers include the h. pylori bacteria and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, Motrin (ibuprofen), and Aleve (naproxen).
Causes of acute bleeding include:
Varices: These are abnormally enlarged veins located at the lower end of the esophagus. Esophageal varices are very rare and usually only occur in patients with severe liver disease like cirrhosis or other conditions that affect blood flow to the liver. Tears: A tear in the lining of the esophagus that is usually caused by prolonged vomiting, but may also be caused by prolonged coughing or hiccuping. This is often called Mallory-Weiss syndrome, which is a disorder of the lower end of the esophagus caused by severe retching and vomiting and characterized by laceration associated with bleeding.
