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What Causes Gastrointestinal Bleeding in the Esophagus

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Updated June 05, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: What Causes Gastrointestinal Bleeding in the Esophagus
Answer:

Bleeding in the esophagus has several possible causes. Since some bleeds can be large and fatal, it is very important for a person to be evaluated by a physician for any GI bleeding. And if someone has any of the symptoms of acute GI bleeding, they should seek emergency treatment immediately. It is also important to know the symptoms of chronic GI bleeding, and to seek medical attention.

Causes of bleeding in the esophagus: can include:

Chronic bleeding:

  • Inflammation (esophagitis): Stomach acid that backs up into the esophagus can cause inflammation, and this inflammation may lead to bleeding.
  • Cancer Most of the length of the esophagus is lined with squamous cells. If a malignant tumor grows here, it's called squamous cell cancer. The areas at the bottom of the esophagus, and where the esophagus joins the stomach, are lined with columnar cells. If a malignant tumor grows here, it's called adenocarcinomas.
  • Ulcers An ulcer can form in the esophagus if stomach acid increases or the mucous layer that coats the lining of the digestive tract decreases. Causes of esophageal ulcers include the h. pylori bacteria and NSAIDs.

Acute bleeding:

  • Varices: These are abnormally enlarged veins located at the lower end of the esophagus. Esophageal varices are very rare, and only occur in patients with severe liver disease or other conditions that affect blood flow to the liver.
  • Tears: A tear in the lining of the esophagus that is usually caused by prolonged vomiting, but may also be caused by prolonged coughing or hiccuping. This is sometimes called Mallory-Weiss syndrome, which is a disorder of the lower end of the esophagus caused by severe retching and vomiting and characterized by laceration associated with bleeding.

Sources:

"Bleeding in the Digestive Tract." NIH Publication No. 07–1133 November 2004. National Digestive Diseases Information Clearinghouse (NDDIC)..

"What You Need to Know About Cancer of the Esophagus - Types of Esophageal Cancer." National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/esophagus/page4

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  5. Causes of Gastrointestinal Bleeding in the Esophagus

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