Causes of gastrointestinal bleeding vary depending on the patient’s age and in what part of their digestive tract the bleeding is occurring.

Bleeding is broadly classified according to the part of the digestive tract in which it occurs: the upper tract, the lower tract, or the small intestine.

In general, bleeding in the upper gastrointestinal tract can be caused by ulcers, enlarged veins in the esophagus, or maybe a tear in the lining of the esophagus that happens during vomiting.

Bleeding in the lower gastrointestinal tract is most likely associated with polyps in the large intestine, diverticular disease, hemorrhoids, inflammatory bowel disease, or possibly colon cancer.

It’s rare for bleeding to occur in the small intestine, but when it does it most often results from tumors, blood vessel abnormalities, or a condition called a Meckel diverticulum.

What to Look For

Gastrointestinal bleeding can happen anywhere along the digestive tract. It may not be immediately obvious to the patient that a bleed is going on. Bleeding that’s deeper inside the digestive tract and that occurs only in small amounts may not be visible to the naked eye; it can only be detected by testing a stool sample.

Heavier bleeding may show up in vomit if the patient gets sick. Bright red blood may be a sign of brisk, ongoing bleeding. Blood can also take on the appearance of coffee grounds if it has been partially digested inside the stomach.

Blood may also appear bright red in the stool. But it can also show up in the stool by making it look black and tarry – a condition called melena. Melena may continue to be present for several days after the gastrointestinal bleeding has actually stopped.

Certain warning signs may be cause for particular concern and may indicate a need for prompt medical treatment. These signs include sweating, fainting, a fast heart rate, or passing more than one cup of blood.

Pradaxa and Gastrointestinal Bleeding

Whatever the cause of gastrointestinal bleeding, persons taking anticoagulant medications like Pradaxa are at greater risk for it.

Pradaxa is one of the newer anticoagulant medications that started to be introduced around 2010. These new drugs were promoted as having advantages over the older anticoagulant warfarin in that they didn’t require continuous blood testing and dosage adjustment.

Keeping Pradaxa Side Effects Under Control

But unlike warfarin, Pradaxa and the other new anticoagulants were introduced to the market with no effective reversal agent that could stop excessive bleeding once it starts. While warfarin users may be able to get gastrointestinal bleeding under control by administering vitamin K, but for the first five years of its use on the market, the only way to remove Pradaxa  from the bloodstream was via dialysis. Some Pradaxa users had to continue bleeding while they wait for the drug’s effect to wear off, and more recently, they have had the antidote Praxabind available to them.

Pradaxa side effects include an increased likelihood that such bleeding will occur. It can also increase the likelihood that gastrointestinal bleeding will be more severe. These risks are natural consequences of Pradaxa doing what it’s supposed to do. By reducing the blood’s ability to clot, Pradaxa can prolong and intensify gastrointestinal bleeding.

In some cases, Pradaxa bleeding can be life-threatening. Some reported adverse events associated with Pradaxa have ended with the patient’s death. At least one study suggests that older women are more susceptible to these particular Pradaxa side effects.