Internal Bleeding: Symptoms, Causes & Treatment

Internal bleeding occurs when bleeding happens inside the body, usually due to the rupture of a vein or artery. It can be caused by trauma, bone fractures, or medical conditions such as hemophilia, gastritis, or Crohn’s disease. Because the bleeding happens internally, it may not be visible at first and can become serious if not treated promptly.

Symptoms of internal bleeding vary depending on the affected area and the severity of the bleed. In some cases, symptoms may take time to appear. Common signs include dizziness, weakness, shortness of breath, confusion, and loss of consciousness.

If you suspect internal bleeding, seek emergency medical care immediately. Treatment must be provided quickly and may involve IV fluids, blood transfusions, or surgery to prevent serious complications.

Signs of internal bleeding

Signs and symptoms of internal bleeding include:

• Dizziness or vertigo;

• Shortness of breath;

• Weakness;

• Rapid heartbeat;

• Nausea and vomiting;

• Fast breathing;

• Low blood pressure;

• Confusion and loss of consciousness.

Hypovolemic shock is a severe condition that occurs when there is a significant loss of blood. Warning signs include pale, cool skin; a bluish or purplish color to the lips and fingertips; and a sensation of faintness or lightheadedness.

Bleeding in the abdomen

Signs of internal bleeding in the abdomen include severe abdominal pain, swelling or a feeling of fullness in the stomach, bruising on the abdomen, and the presence of blood in the vomit, urine, or stool.

Bleeding in the uterus

Symptoms of internal bleeding in the uterus include abnormal vaginal bleeding, pelvic pain or intense cramping, weakness, and dizziness. In severe cases, signs of shock may appear, such as pale skin and a rapid heartbeat.

Possible causes

Internal bleeding occurs when a vein or artery ruptures. This can happen due to several reasons, such as:

• Trauma, including car accidents, assaults, or falls;

• Bone fractures, especially in large bones like the femur or pelvis;

• A ruptured aneurysm, such as an aortic or brain aneurysm;

• Gastrointestinal problems like ulcers, gastritis, Crohn’s disease, polyps, colitis, esophageal varices, hemorrhoids, or gastrointestinal cancer;

• Blood clotting disorders, such as hemophilia or vitamin K deficiency, or the use of anticoagulant medications;

• Gynecological conditions, such as a ruptured ovarian cyst, ectopic pregnancy, or postpartum bleeding;

• Severe viral infections, including Ebola, dengue hemorrhagic fever, hantavirus, or yellow fever.

Certain factors can also increase the risk of internal bleeding, including chronic high blood pressure, deep vein thrombosis, excessive use of anti-inflammatory medications like ibuprofen or aspirin, and heavy alcohol or drug use.

Internal bleeding can also occur hours or even days after surgery, and it may require a return to the hospital to stop the bleeding.

Treatment options

The treatment for internal bleeding depends on the cause, location, and severity of the bleed.

During initial stabilization, IV fluids and blood transfusions are used to restore blood volume, and oxygen is provided if there is breathing difficulty.

Surgery may be needed to help control bleeding in cases of ruptured organs, aneurysms, or major blood vessels. In some cases, a minimally invasive procedure called embolization can be used to block bleeding vessels.

Medications such as anticoagulants or anti-inflammatories may be adjusted or stopped, when necessary, to treat the underlying condition.

The person will continue to be closely monitored with frequent blood tests and organ function assessments. Admission to the intensive care unit (ICU) may be required in severe cases or when shock occurs.

Possible complications

1. Hypovolemic shock;

2. Organ failure, which may affect the kidneys, liver, lungs, or brain;

3. Coma.

Because these complications can be life-threatening, it is essential to seek medical help as soon as any symptoms of internal bleeding appear.

Can internal bleeding be fatal?

Yes. Internal bleeding can be fatal, especially if the bleeding is severe or not treated promptly. Major blood loss can cause shock, deprive the organs of oxygen, and lead to organ failure, putting the person’s life at risk.