Diagnosis at Mayo Clinic

Mayo Clinic doctors start by asking you about your symptoms and by doing a thorough physical examination and blood tests. This initial exam may be enough to indicate a cause of GI bleeding.

But if the source isn't obvious, Mayo Clinic doctors can use sensitive imaging technologies to find it. Results from one procedure determine the next procedure to use until the cause is determined.

Mayo doctors use these tests:

  • Upper endoscopy. This procedure — also called esophagogastroduodenoscopy — uses a scope to inspect your esophagus and stomach, as well as the upper part of your small intestine (duodenum). The doctor may remove a small tissue sample (biopsy) for further study and in some cases control or treat the bleeding source.
  • Colonoscopy. This test uses a long, flexible tube to provide video images of your rectum and colon. In some cases, bleeding can be controlled or treated during a colonoscopy.
  • Capsule endoscopy. You swallow a small pill containing a video camera, which transmits images of your small intestine to a recording device.
  • Balloon-assisted enteroscopy. A specialized scope inspects parts of your small intestine that esophagogastroduodenoscopy and colonoscopy can't reach. Sometimes, the source of bleeding can be controlled or treated during this test.
  • Endoscopic ultrasound. An ultrasound probe attached to an endoscope allows doctors to see all the layers of tissue in the digestive tract.
  • Endoscopic retrograde cholangiopancreatography (ERCP). A scope combined with an X-ray procedure allows doctors to see the ducts of the gallbladder, liver and pancreas. However, this test is rarely needed in the evaluation of GI bleeding.
  • Multiphase CT enterography or magnetic resonance (MR) enterography. Mayo Clinic researchers helped develop these noninvasive radiologic tests, which are more sensitive than conventional X-rays for finding the source of GI bleeding. These tests can provide images of the entire thickness of the bowel wall, all of the long loops in the small intestine and all layers of surrounding tissue.
  • Angiography. A contrast dye is injected into an artery, and a series of X-rays are taken to look for and treat bleeding vessels or other abnormalities.

If your GI bleeding is severe, and noninvasive tests can't find the source, you may need surgery so that doctors can view the entire small intestine. Fortunately, this is rare.


Treatment at Mayo Clinic

Mayo Clinic specialists have a variety of treatment options that may be used in combination, depending on the source of your GI bleeding:

  • Endoscopic thermal probe. This treatment can stop bleeding from ulcers and other abnormalities by burning (coagulating) the blood vessel or abnormal tissue.
  • Endoscopic injection. With endoscopic injection, your doctor can stop the bleeding by injecting a liquid, such as diluted epinephrine, at the source of the bleeding.
  • Argon plasma coagulation and radiofrequency ablation are other types of thermal techniques used to treat abnormal blood vessels in the stomach, small intestine and colon.
  • Endoscopic clips can be used to close a bleeding vessel or other defective tissue.
  • Endoscopic band ligation uses special bands to treat bleeding hemorrhoids and bleeding blood vessels (varices) in the esophagus.
  • Endoscopic intravariceal cyanoacrylate injection uses a special glue to treat difficult bleeding from varices in the stomach.
  • Angiographic embolization injects particles directly into a blood vessel to stop bleeding.

If bleeding recurs after treatment, you may need a repeat evaluation and treatment. Although it's rare, you may need surgery.

Once the source of the bleeding is identified and stopped, the next step is to treat the condition that caused the bleeding in the first place.

Gastrointestinal bleeding care at Mayo Clinic

Oct. 21, 2015
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