Internal Bleeding

Symptoms accompanying internal bleeding vary based on the location and speed of blood loss. Pain may or may not be present. Rapid bleeding can quickly cause weakness, dizziness, shock and unconsciousness. Slower bleeding may ultimately cause anemia, with the gradual onset of tiredness, weakness, shortness of breath, and pallor. Bleeding into the gastrointestinal or urinary tract can cause blood in the stool, vomit or urine.

Internal bleeding in the head may accompany other symptoms including:

• Change in mental status

• Confusion

• Garbled or slurred speech or inability to speak

• Headache

• Loss of vision or changes in vision

• Numbness or tingling

• Paralysis

• Weakness (loss of strength)

Internal bleeding in the chest or abdomen may accompany other symptoms including:

• Abdominal, pelvic, or lower back pain that can be severe

• Abdominal swelling, distension or bloating

• Bruising around the navel or of the flanks

• Chest pain

• Coughing up blood (hemoptysis)

• Difficulty breathing

• Dizziness or lightheadedness

• Enlarged liver or spleen

• Shortness of breath

Internal bleeding into the muscles or joints may accompany other symptoms including:

• Bone or joint deformity

• Loss of sensation

• Pain

• Reduced mobility (range of motion)

• Swelling, redness or warmth

Internal bleeding at other sites may accompany other symptoms including:

• Abdominal pain or cramping

• Bloody or pink-colored urine (hematuria)

• Bloody stool (blood may be red, black, or tarry in texture)

• Hematoma (collection of blood in body tissues)

• Pain

• Vomiting blood or black material (resembling coffee grounds)

In some cases, internal bleeding may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medica l care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

• Bleeding while pregnant

• Bluish coloration of the lips or fingernails

• Change in level of consciousness or alertness, such as passing out or unresponsiveness

• Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

• Chest pain, chest tightness, chest pressure, palpitations

• Garbled or slurred speech or inability to speak

• Not producing any urine, or an infant who does not produce the usual amount of wet diapers

• Paralysis or inability to move a body part

• Rapid heart rate (tachycardia)

• Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing

• Severe pain

• Vomiting blood, rectal bleeding, or bloody stool

Internal bleeding can occur as a result of trauma or with a variety of medical conditions. The risk is increased with clotting abnormalities and anti-clotting medications.

Although internal bleeding is often due to trauma, it may also be caused by a variety of conditions including:

• Anticlotting medications

• Arteriovenous malformation (abnormal connections between arteries and veins)

• Gastritis (inflammation of the stomach lining)

• Gastroenteritis (infection of the digestive tract)

• Hemophilia (rare hereditary disorder in which blood does not clot normally)

• Inflammatory bowel disease (includes Crohn’s disease and ulcerative colitis)

• Liver disease (includes any type of liver problem, such as hepatitis, cirrhosis and liver failure)

• Medication side effects, especially nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and indomethacin (Indocin)

• Ruptured aneurysm (rupture of a weakened, bulging area of an artery)

• Thrombocytopenia (low blood platelet count; platelets help form clots to stop blood loss)

• Von Willebrand’s disease (hereditary bleeding disorder)

In some cases, internal bleeding may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

• Bleeding esophageal varices (life-threatening rupture and hemorrhage of swollen veins in the esophagus)

• Bowel infarction (severe bowel injury due to decreased blood supply)

• Ectopic pregnancy (life-threatening pregnancy growing outside the uterus)

• Head injury

• Ruptured aortic aneurysm (rupture of a weakened, bulging area of the aorta)

• Ruptured liver or spleen

• Trauma, such as bone deformity, eye injuries, and other injuries

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your internal bleeding including:

• When did you first notice your symptoms?

• Have you been feeling tired or dizzy?

• Have you noticed any blood in your stool or urine?

• Have you been having any pain?

• Do you have any other symptoms?

• Do you have any preexisting health problems?

• What medications are you taking?

Because internal bleeding can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

• Altered or decreased sensation

• Anemia (low red blood cell count)

• Brain damage

• Organ failure

• Paralysis or weakness (loss of strength)

• Shock

• Unconsciousness and coma