What is a GI Bleed?
Gastrointestinal (GI) bleeding is bleeding from the digestive tract. GI bleeding can be caused by liver disease, stomach inflammation or ulcers, certain medications, diverticulosis, cancer, inflammatory bowel disease, abnormal blood vessels (angiodysplasia), and weak veins (varices or hemorrhoids).
Bleeding from the upper part of the digestive tract can result in vomiting of blood that is bright red or black, like coffee grounds. Bleeding from the lower part of the digestive tract can result in bloody stool or dark tar-like stool. The loss of blood can make a person feel tired or look pale from low blood cells (anemia). Doctors can look for the bleed using a small camera (scope) from the mouth (endoscopy, or EGD) or from the rectum (colonoscopy or sigmoidoscopy).
What is Embolization and how is it done?
Embolization is a minimally invasive treatment for GI bleeding. It is often recommended when other treatments fail.
You will be given medicine to keep you comfortable. The clinician numbs the skin on your groin or wrist and then threads a small tube into a blood vessel through a pinhole in the skin and uses x-rays and dye to guide it through to the blood vessel that is bleeding. They will inject special material to block the bleeding blood vessel. Common materials include a slurry called gelfoam, tiny beads, metallic coils or plugs, or medical grade super glue. What they choose to use depends on which vessel is bleeding and why.
Embolization is often successful. It stops bleeding in the upper part of the digestive tract in 5-9 in 10 people. It stops bleeding in the lower part of the digestive tract in 8-9 in 10 people.
Embolization for GI Bleed
1. After numbing the skin, a small tube is placed into the blood vessel at the top of the thigh (shown) or wrist.
2. They guide the tube to the blood vessel that is bleeding and inject special material (gelfoam shown) to stop the bleeding.
3. Once the blood vessel stops bleeding, the clinician removes the tube and places a bandage over the pinhole in the skin.
What are the risks?
Embolization for gastrointestinal bleeding is generally a safe procedure when done by a specialist.
6 in 100 people develop permanent damage to the intestines or bowels requiring surgery.
Other risks of the procedure include:
damage to other blood vessels
damage to nearby organs or tissues if their blood vessels are also blocked while blocking the bleeding blood vessel
damage to the kidneys
allergic reaction from the contrast dye
2-20 in 100 people:
temporary bleeding or bruising around the skin wound
infection
abdominal pain
What are the alternatives?
Your treatment options depend on your preferences, overall health and unique conditions.
Alternative 1 No procedure. In most cases, the bleeding area heals on its own or with medicines. Some people will continue to bleed or will bleed so much that it becomes life-threatening. Blood transfusions can replace lost blood.
Alternative 2 Endoscopy. A scope is a small camera that is passed through the mouth into the stomach (called an endoscopy) or through the rectum and into the intestines (called a colonoscopy or sigmoidoscopy). Doctors may use lasers, clips, or bands to try to stop the bleeding.
Alternative 3 Surgery to repair the problem. This option has the highest risk, so it is only used in emergencies or when nothing else works.