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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Any Suggestion For Gastrointestinal Bleeding With Normal Colonoscopy?

GI Bleeds, colonoscopy revealed nothing. Taking several drugs now for a very long time but I keep being told no problems . Last GI bleed was 9 pints of whole blood, 3 bags or plasma and 3 liters of water-like fluid. Had another bleed two days ago but it stopped after 4th bowel. Any ideas?
Fri, 24 Feb 2017
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General Surgeon 's  Response
Hi.
Thanks for your query.
Noted the history of normal colonoscopy but hte GI bleeding needing 9 pints of blood, 3 bags of plasma and 3 bottles of intravenous fluid. Had another bleed but stopped after 4 the bowel movement.
This means there is a cause that has not yet been found.
I would advise you the following in such a situation:
Upper GI Endoscopy.
Contrast enhanced CT scan.
Camera Endoscopy when there is bleeding to see for any spot the is causing the bleeding.
The cause if not found in the stomach then would be vascular malformation.
One may need exploratory laparotomy to find the cause and treat it accordingly.
Also needed the blood tests for CBC, bleeding time, clotting time, prothrombine tine with INR values and others as needed. Also see for calcium, electrolytes, proteins and liver function tests to find out any primary cause. and get treated accordingly.
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Any Suggestion For Gastrointestinal Bleeding With Normal Colonoscopy?

Hi. Thanks for your query. Noted the history of normal colonoscopy but hte GI bleeding needing 9 pints of blood, 3 bags of plasma and 3 bottles of intravenous fluid. Had another bleed but stopped after 4 the bowel movement. This means there is a cause that has not yet been found. I would advise you the following in such a situation: Upper GI Endoscopy. Contrast enhanced CT scan. Camera Endoscopy when there is bleeding to see for any spot the is causing the bleeding. The cause if not found in the stomach then would be vascular malformation. One may need exploratory laparotomy to find the cause and treat it accordingly. Also needed the blood tests for CBC, bleeding time, clotting time, prothrombine tine with INR values and others as needed. Also see for calcium, electrolytes, proteins and liver function tests to find out any primary cause. and get treated accordingly.