Internal bleeding refers to bleeding that occurs inside the body due to the rupture of veins or arteries. It can be caused by trauma or fractures, but it can also occur due to diseases such as hemophilia, gastritis or Crohn's disease. Internal bleeding can also be a side-effect of anticoagulants or anti-inflammatories.

Symptoms of internal bleeding depend on where it is occurring and the severity of the injury. It may not present with any symptoms at first, however as it progresses, it can lead to symptoms like dizziness, weakness, shortness of breath, confusion or even loss of consciousness.

If you notice symptoms of internal bleeding, you should seek medical attention immediately and proceed to the nearest emergency room. Treatment should be initiated as soon as possible to prevent life-threatening complications. It may involve surgery, IV fluids or a blood transfusion.

Common symptoms

The symptoms of internal bleeding include:

Dizziness and loss of balance
Weakness and numbness on one side of the body
Sudden and severe headache
Intense abdominal pain
Blood in urine or stool
Cold sweat
Difficulty swallowing or chewing
Shortness of breath and chest pain
Coughing up blood
Nausea and vomiting
Changes in vision or hearing
Diarrhea
Lack of motor coordination
Drowsiness
Loss of consciousness or fainting

Prolonged internal bleeding may lead to hypovolemic shock, which occurs as a consequence of massive blood losses. This condition presents with symptoms like pale and cold skin, heart palpitations, confusion and purple fingers and lips.

It is important to seek medical help immediately or proceed to the nearest emergency room if you experience symptoms of internal bleeding, so that treatment can be initiated promptly.

Confirming a diagnosis

An internal bleeding diagnosis is first confirmed through an assessment of the patient's symptoms, health history and blood test results. The blood tests can be ordered to determine how severe the bleeding is.

The doctor may also request additional imaging tests, such as an ultrasound, CT scan, MRI or or angiography to determine the location of the bleeding, the severity of the bleeding and to evaluate any surrounding blood vessels.

Other tests that the doctor may request are a stool test in the stool, an endoscopy, or a colonoscopy, especially in cases where gastrointestinal bleeding is suspected.

Possible causes

Internal bleeding is related to the rupture of veins or arteries that can be caused by:

Trauma, from a car accidents, sports injury or fall
Bone fractures, especially in the bones of the leg, pelvis or arm
Brain or aortic aneurysm
Blood clotting disorders, such as hemophilia or vitamin K deficiency, and use of anticoagulant medications
Ectopic pregnancy
Chronic high blood pressure
Deep vein thrombosis
Cancer or tumor in the intestines, stomach, esophagus, bladder, lung, uterus or leukemia
Liver, gallbladder or kidney disease
Use of anti-inflammatory medications, such as ibuprofen or acetylsalicylic acid
Excessive or long-term consumption of alcohol, as this can lead to cirrhosis
Drug abuse
Viral infections, such as dengue, Chikungunya, Ebola, hantavirus or yellow fever

Gastrointestinal diseases like intestinal polyps, stomach ulcers, colitis, esophageal varices, Crohn's disease, celiac disease, gastroenteritis or esophagitis can also cause internal bleeding in the stomach or abdomen.

Internal bleeding may also be observed in some patients hours or even days after surgery, which will require urgent reassessment and correction.

Treatment options

Treatment for internal bleeding should be guided by a doctor and is aimed at determining the site of bleeding and stopping it. Treatment varies depending on the underlying cause, the extent of the bleeding, the patient's status, and the organ, tissue or vessel that is affected.

Mild internal bleeding can resolve on its own without the need for treatment. However, in most cases, urgent surgical repair is necessary, as massive blood losses can be life-threatening. IV fluids or a blood transfusion may be necessary to replace the volume of blood lost and prevent further complications.

Possible complications

Some complications related to internal bleeding include:

Hypovolemic shock
Organ failure, affecting the kidneys, liver, lungs or brain
Coma

Therefore, it is important to seek medical assistance if you notice any symptoms of internal bleeding to prevent complications, as they can be life-threatening.