gastrointestinal bleeding

Last reviewed 10/2023

Haematemesis, melaena or massive rectal bleeding are dramatic signs of gastrointestinal haemorrhage. It is important in such a case to assess the amount of blood loss and to determine the likely site of bleeding.

  • haematemesis indicates bleeding proximal to or including the duodenum
  • melaena usually results from upper gastrointestinal bleeding, although right-sided colonic and small bowel lesions can occasionally be responsible
  • massive rectal bleeding is usually from the distal colon, rectum or from a major bleeding site higher in the gastrointestinal tract

It is necessary to:

  • assess and replace blood loss
  • diagnose the source of blood loss
  • treat and control of source of bleeding