Internal Bleeding: What is it? Symptoms, Causes, Diagnosis and Treatment

Internal bleeding is not so easy to see or diagnose. It is often the result of trauma or injury.

Internal bleeding is bleeding that occurs inside your body. An injury that damages the outside of your body is easy to see. A cut or tear in your skin usually bleeds, you can see what hurts and it’s probably easy to determine what caused it.

On the other hand, in internal bleeding, the less obvious causes can also cause internal hemorrhages. These include gastritis, organ damage or a bleeding disorder .

When internal bleeding occurs, you need medical attention. In some cases, bleeding can be a sign of a life-threatening condition and you should seek immediate medical attention.

Signs and symptoms of internal bleeding

If you or someone you know suddenly develops the following symptoms, seek immediate medical attention:

  • Dizziness.
  • Severe weakness
  • Fainting.
  • Low blood pressure .
  • Sharp visual problems.
  • Numbness.
  • Weakness on one side of the body.
  • Intense headache.
  • Severe abdominal pain.

These could be symptoms of internal bleeding.

You may also have the following symptoms:

  • Difficulty breathing.
  • Chest pain.
  • Nausea.
  • Vomiting
  • Diarrhea.

In addition, you may notice vomiting or stools with blood or darkness. Occasionally, if the bleeding is behind the internal organs in the abdomen. You may have bruising around the belly button or on the sides of the abdomen.

Other cases of internal bleeding may be less severe, but it is still important to see your doctor as soon as you notice the signs and symptoms.

Internal bleeding is a symptom of an injury, condition or illness. You will not begin to experience internal bleeding without an underlying reason.

Recognizing the signs and symptoms of internal bleeding can help you and your doctor understand what is bleeding, why you are bleeding, and what conditions may be contributing to the problem.

Internal bleeding in your head:

This can cause:

  • Weakness, usually on one side of your body.
  • Numbness, usually on one side of your body.
  • Tingling, especially in the hands and feet.
  • Severe and sudden headache
  • Difficulty swallowing or chewing.
  • Change in vision or hearing.
  • Loss of balance, coordination and ocular focus.
  • Difficulty speaking or understanding speech.
  • Difficulty writing.
  • Changes in general alertness, including increases in drowsiness, lethargy or stupor.
  • Loss of consciousness.

Internal bleeding in your chest or abdomen:

This can cause:

  • Abdominal pain.
  • Difficulty breathing.
  • Chest pain.
  • Dizziness, especially when standing.
  • Bruising around your belly button or on the sides of your abdomen.
  • Nausea.
  • Vomiting
  • Blood in the urine.
  • Black, tarry stools.
  • Bleeding from another cavity, including ears, nose, mouth or anus.

Internal bleeding in your muscles or joints:

This can cause:

  • Pain in a joint.
  • Swelling in a joint.
  • Range of movement decreased.

Other symptoms

It is possible to experience shock in some cases of internal bleeding, especially in places where a considerable amount of blood may be lost, such as the chest, abdomen or thigh.

The shock occurs when there is not enough blood to supply your entire body.

Symptoms of shock include:

  • Fast beats
  • Low blood pressure.
  • Sweaty skin
  • Changes in general alertness, including increases in drowsiness, lethargy or stupor.

General weakness

The presence of other underlying conditions can help doctors recognize that you are losing blood somewhere.

For example, anemia is commonly associated with a slow and chronic internal hemorrhage. It can cause fatigue, weakness and difficulty breathing.

Some people with internal bleeding also experience low blood pressure due to constant blood loss. This is called orthostatic hypotension .

Common symptoms include feeling dizzy or dazed when you stop.

Causes of internal bleeding

Sometimes, identifying what is causing internal bleeding is easy. If you were involved in an accident or had a recent injury, bleeding is likely to be the result of that event.

Similarly, diagnosing the cause can be easy if you were diagnosed with a condition that can lead to internal bleeding, such as gastroenteritis .

However, not all cases of internal bleeding are so clear. Finding the source of an internal hemorrhage can take a while and a thorough examination.

Non-traumatic causes

These may include:

Damage to a blood vessel: minor tears can occur with an injury.

There are not enough coagulation factors: your body produces proteins to stop bleeding if it is cut or injured. If your body does not have enough clotting factors, you can bleed freely.

Certain medications: Certain medications, such as anticoagulants, can prevent clotting and cause serious bleeding if you are injured or have an accident.

Certain over-the-counter medications, including aspirin, can also damage the lining of the stomach.

Chronic high blood pressure : high blood pressure weakens the walls of blood vessels. Weak walls can form aneurysms that can rupture and bleed.

Inherited coagulation disorders: hemophilia is a genetic condition that prevents blood from clotting properly. A minor injury can bleed a lot if it is not treated properly.

Gastrointestinal (GI) Causes: Bleeding in the abdomen or stomach may be due to one of several GI conditions. These include colon polyps, colitis , Crohn’s disease , gastroenteritis, esophagitis , peptic ulcers and more.

Lifestyle factors: alcohol, tobacco and illicit drugs can irritate the lining of the stomach.

Causes that threaten life

These may include:

Trauma: Car accidents, falls, physical assaults and throwing a heavy object on you are examples of ways you can damage organs, blood vessels and bones in your body.

You may experience internal bleeding without cutting your skin.

Aneurysms: weak walls of blood vessels can bulge and form pockets of blood. Many aneurysms do not cause any symptoms, but a bursting aneurysm is life-threatening.

Broken bones: most broken bones are nothing to worry about, but breaking the larger bones of your body, such as the femur, can cause significant internal bleeding.

Ectopic pregnancy: a pregnancy outside the uterus can cause internal bleeding as the fetus grows. The condition can endanger life.

Surgery: before a surgeon completes an operation, they make sure that all bleeding has stopped. If they lose something, the bleeding may continue even after the incision is closed.

In some cases, this bleeding can be severe.

No matter the cause, it is important that you receive medical attention. Mild internal bleeding can quickly become severe if the cause is not identified and treated quickly.

Diagnosis of internal bleeding

The diagnosis of an internal hemorrhage usually requires medical examinations, a physical examination and a thorough review of your medical history.

Your doctor can use a variety of laboratory tests and imaging tools to identify the cause of your internal bleeding and measure the severity.

For traumatic injuries, an imaging test may be all that is necessary. The tests to order can also be obvious.

If you suffered an accident and injured your right leg, your doctor will request tests that look at your right leg. An x-ray can show the bones.

A CT scan is an advanced x-ray that can see bones, tissues, and blood vessels. Angiography is an imaging test that can carefully examine individual blood vessels.

If the cause of the bleeding is not so obvious, your doctor may order several medical tests to help identify what is bleeding and why.

These medical tests may include a stool test and several blood tests. Depending on your signs and symptoms, your doctor may also request several types of imaging tests.

Treatment

Treatment options

The first goal of treatment is to find the source of the bleeding and stop it. Some bleeding is minor and can stop on its own.

Other cases are more serious and may require more invasive measures, including surgery.

When your doctor considers a treatment for internal bleeding, you are likely to consider three factors:

  • The severity of the cause.
  • The organ or blood vessel that is injured.
  • Your general health

In mild cases of internal bleeding, treatment usually involves rest and control of symptoms. Rest gives your body time to heal as it reabsorbs the blood and the swelling goes down.

Few other treatment techniques may be necessary for slow bleeding once the cause is identified and treated.

However, some causes of internal bleeding need further treatment. Surgery may be necessary to stop the bleeding and clean any accumulated blood. The type of surgery you need depends on how bad the bleeding is, where the bleeding is and your general health.

After the bleeding stops, treatment will focus on repairing any damage caused by bleeding and stabilizing your body.