Gastrointestinal Bleeding: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Gastrointestinal Bleeding?
A gastroenterologist, a doctor who treats digestive system problems, usually finds and treats the cause of gastrointestinal (GI) bleeding. Sudden or severe bleeding needs medical help right away. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is gastrointestinal bleeding?
Gastrointestinal (GI) bleeding is bleeding that starts somewhere in the digestive tract.
Acute bleeding begins suddenly and can sometimes be severe. Chronic bleeding may cause a small amount of blood in your stool. If the amount is too small for you or your doctor to see, it is called occult bleeding.
Symptoms
Symptoms depend on the type of GI bleeding you have. Acute GI bleeding may cause:
- Black or tarry stool.
- Dark or bright red blood mixed with stool.
- Bright red blood in vomit.
- Vomit that looks like coffee grounds.
- Cramps or pain in your abdomen.
- Fainting or feeling lightheaded or dizzy.
- Feeling tired or short of breath.
If acute bleeding is severe, you could go into shock. Shock is life-threatening.
Over time, chronic bleeding can cause anemia, with symptoms such as feeling tired, pale skin, and shortness of breath.
Causes and who gets it
Many diseases and conditions can cause GI bleeding, depending on where in the GI tract it happens. Common causes of upper GI bleeding include:
- Peptic ulcers, which are sores on the lining of the stomach or duodenum. The most common causes are Helicobacter pylori (H. pylori) infection and taking NSAIDs or blood thinners.
- Gastritis, which is an inflamed or damaged stomach lining.
- Varices, which are enlarged veins in the esophagus or stomach and are most often related to cirrhosis.
- Benign tumors or cancer in the esophagus or stomach.
Common causes of lower GI bleeding include:
- Diverticular disease, in which small pouches form in the wall of your colon and a small blood vessel in a pouch can burst.
- Hemorrhoids, which are swollen and inflamed veins around your anus or in your lower rectum, or anal fissures, which are small tears.
- Polyps, benign tumors, or cancer in the colon or rectum.
- Colitis, which is inflammation in the colon, often from poor blood flow, inflammatory bowel disease, or infections.
How doctors diagnose it
Your doctor will ask about your medical and family history and do a physical exam. They will ask about your medicines, including over-the-counter NSAIDs and blood thinners.
Common tests include:
- Stool tests, which can show occult bleeding.
- Blood tests, which can show how severe the bleeding is and whether you have anemia.
- Endoscopy, which uses a long, flexible, narrow tube with a light and tiny video camera to look inside the GI tract. Types include upper GI endoscopy, enteroscopy for the small intestine, and colonoscopy for the rectum and colon.
- Angiography, which uses dye and X-rays to show how blood flows through your blood vessels.
In some cases, doctors can diagnose and treat the bleeding at the same time.
Treatment
Treatment depends on how severe the bleeding is, its cause, and where in the GI tract it happens. During an endoscopy, a doctor can use tools to inject medicines into the bleeding site, seal the blood vessel with an electric current, apply a band or clip, or spray a powder or gel.
Doctors may recommend medicines to treat causes of GI bleeding, such as peptic ulcers, gastritis, and inflammatory bowel disease. If you have severe bleeding or bleeding that does not stop after other treatments, you may need surgery. NSAIDs may increase the chance of GI bleeding, and blood thinners may increase the chance or the severity of a bleed. Follow your doctor's instructions about your medicines.
When to see a doctor
If you have black or tarry stool, seek medical help right away. Call 911 or go to the emergency room if you vomit blood, vomit something that looks like coffee grounds, faint, have trouble breathing, or have bleeding that will not stop. Also call 911 for signs of shock, which are confusion, a fast heart rate, pale skin, cold hands and feet, or sweating.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A doctor like this can review your symptoms and medicines and order first blood or stool tests. They can also refer you to a gastroenterologist and help you follow your treatment plan after bleeding is controlled.
Common questions
Is GI bleeding an emergency?
It can be. Acute GI bleeding begins suddenly and can sometimes be severe, and severe bleeding can lead to shock, which is life-threatening. Call 911 or go to the emergency room if you vomit blood or coffee-ground material, faint, or have signs of shock.
What does black or tarry stool mean?
Black or tarry stool can be a sign of GI bleeding. It can happen with sudden bleeding, and also with long-term bleeding. If you see black or tarry stool, seek medical help right away.
Can GI bleeding happen without visible blood?
Yes, chronic GI bleeding can involve so little blood that you or your doctor cannot see it. Stool and blood tests can check for it. Over time, this kind of bleeding can cause anemia.
Can medicines cause GI bleeding?
Yes, some medicines can raise the chance of GI bleeding. NSAIDs, which include aspirin, ibuprofen, and naproxen, can cause peptic ulcers that bleed. Blood thinners may increase the chance of bleeding or how severe it is.
Sources
- NIDDK - Symptoms & Causes of GI Bleeding
- NIDDK - Diagnosis of GI Bleeding
- NIDDK - Treatment for GI Bleeding
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
