Gastrointestinal bleeding can begin suddenly and, depending on how much blood is lost and where the bleeding comes from, can become a medical emergency. Blood in the vomit, black tarry stools, dizziness, weakness or fainting are signs that require prompt medical attention. At STAR Hospitals, gastrointestinal bleeding is managed through a dedicated gastroenterology service, with emergency evaluation, endoscopic treatment and, when necessary, support from hepatology, critical care, interventional radiology and surgery.
One of the techniques used in appropriate cases is endoscopic sclerotherapy, in which a sclerosant is injected through an endoscope to help control bleeding from selected blood vessels.
Where Does Endoscopic Sclerotherapy Fit in GI Bleeding?
Gastrointestinal bleeding has several possible causes: Peptic ulcers, erosions and tears can bleed, while people with advanced liver disease may develop oesophageal or gastric varices—enlarged veins that can rupture and cause significant bleeding.
The treatment depends on the source. In variceal bleeding, endoscopic treatment may include injection sclerotherapy or endoscopic variceal ligation (banding). Sclerotherapy involves injecting a suitable sclerosant into or around the bleeding varix to promote clot formation and control the haemorrhage.
It is important to understand that an endoscopy in this setting is more than a diagnostic examination. The gastroenterologist can locate the bleeding point and, where appropriate, treat it during the same procedure.
STAR Hospitals houses a dedicated department for endoscopic haemostasis for GI bleeding, with techniques including,
- injection of sclerosants
- haemoclips
- thermal therapy
- argon plasma coagulation and other haemostatic methods.
The gastroenterology team also provides endoscopic treatment for both variceal and non-variceal bleeding.
How Is the Procedure Performed?
An upper GI endoscopy uses a thin, flexible endoscope with a camera to examine the oesophagus, stomach and duodenum. Once the source of bleeding is identified, the gastroenterologist selects the appropriate method of haemostasis.
For sclerotherapy, the injection is delivered through the endoscope using specialised equipment. The aim is to stop active bleeding and reduce the risk of continued blood loss. The exact technique and choice of treatment depend on the location and nature of the bleeding, the patient's overall condition and whether the bleeding is related to varices or another lesion.
Not every case of GI bleeding requires sclerotherapy. Clips, thermal coagulation, band ligation, injection therapy or other approaches may be more suitable in a particular patient. This is why identifying the source of bleeding quickly matters.
Why Rapid Treatment Matters
A significant GI bleed can lead to a fall in haemoglobin, low blood pressure and, in severe cases, circulatory instability. The initial management therefore involves more than stopping the bleeding itself. Patients may require intravenous fluids, blood products where indicated, medication and close monitoring while the source is investigated.
STAR Hospitals’ gastroenterology services handle life-threatening GI bleeding emergencies, while its hepatology service has a 24/7 gastrointestinal bleeding service with on-call endoscopists, on-site resuscitation and triage at admission.
What If Endoscopy Cannot Control the Bleeding?
Some bleeds are difficult to control endoscopically, or they may recur despite initial treatment. In such situations, the next step depends on the source and severity of bleeding.
This is where having multiple specialist services working together becomes important. STAR Hospitals offers Interventional Radiology service such as embolisation for GI bleeding, and the gastroenterology and the surgical gastroenterology team manages complex GI conditions and emergencies. For patients with advanced liver disease and variceal bleeding, the hospital also provides procedures such as TIPS/DIPS and BRTO/PARTO through its interventional radiology service.
For a patient and family, this means that treatment can progress from emergency stabilisation and endoscopic haemostasis to radiological or surgical intervention when clinically necessary, rather than relying on one procedure alone.
GI Bleeding Care at STAR Hospitals
STAR Hospitals' Medical Gastroenterology Department at Banjara Hills and Nanakramguda provides diagnostic and therapeutic endoscopy, including upper GI endoscopy, colonoscopy, ERCP, EUS and double-balloon enteroscopy. The department performs more than 200 endoscopic procedures each month and treats gastrointestinal and liver conditions ranging from ulcers and cirrhosis to complex GI bleeding.
For someone experiencing vomiting of blood, black stools, faintness or sudden weakness, the priority is immediate medical assessment. Once the patient is stabilised, endoscopy can help identify where the bleeding is coming from and, in suitable cases, allow treatment such as endoscopic sclerotherapy to be performed without an open surgical procedure. Book an appointment today to know more
