Internal Bleeding

Overview

Internal bleeding means blood is leaking from a blood vessel inside the body. It can be hidden, or it may show up as blood in vomit, stool, urine, or cough. It is a sign of another problem, not a condition on its own. Some causes are minor, but internal bleeding can also be serious, so it is important to get medical advice early if you are worried.

Internal bleeding is a common reason for emergency care, but the chance of it happening to any one person depends on the cause and their health history. Many people are assessed for suspected internal bleeding every day, and most causes can be treated.

Anyone can have internal bleeding, including children and healthy adults, especially after an injury. Risk is higher in older adults, people taking medicines that increase bleeding risk, people with liver disease or bleeding disorders, and people who have had recent surgery or a serious fall.

Symptoms

Common symptoms

• Blood in vomit, which may look bright red or like coffee grounds
• Black, tarry, or bloody stools
• Blood in the urine, or urine that looks pink, red, or dark
• Coughing up blood
• Unusual vaginal bleeding that is not part of a normal period
• Pain, swelling, or tenderness in the belly, chest, or a limb
• Easy bruising or small red or purple spots on the skin
• Feeling dizzy, weak, very tired, or short of breath
• Pale skin, fast heartbeat, or feeling faint

Symptoms in children

• Unexplained irritability, sleepiness, or poor feeding
• Vomiting blood or material that looks like coffee grounds
• Black or bloody stools
• Swelling or pain in the belly after an injury
• Pale skin, weakness, or unusual tiredness
• Crying that cannot be soothed after a fall or accident

Symptoms in older adults

• Confusion or new drowsiness, which can be an early sign of blood loss
• Dizziness or fainting, especially after a fall
• Weakness, shortness of breath, or a fast heartbeat
• Easy bruising or bleeding that seems out of proportion to an injury
• Black stools or blood in vomit or urine, which may be missed if memory or communication is affected

Causes

Main causes

• Injury or trauma, such as a fall, car crash, or blow to the body
• Ulcers or irritation in the stomach or bowel
• Problems with blood vessels, such as a weakened or bulging blood vessel
• Liver disease and enlarged veins in the food pipe or stomach
• Bleeding disorders or problems with blood clotting
• Medicines that increase the risk of bleeding
• Complications after surgery or a medical procedure
• Some cancers or growths in the bowel, stomach, or other organs
• Infections that affect blood vessels or organs
• Pregnancy complications, such as bleeding around the placenta

Risk factors

• Older age
• Taking blood-thinning medicines or long-term anti-inflammatory painkillers
• Liver disease or heavy alcohol use
• A personal or family history of a bleeding disorder
• Recent injury, fall, surgery, or medical procedure
• Conditions that affect platelets or the way blood clots
• Serious infections or long-term illnesses
• Pregnancy

When to see a doctor

See a doctor urgently if:

• You see blood in vomit, stool, or urine
• You have black, tarry stools
• You have new or unexplained bruising or bleeding
• You feel dizzy, weak, or faint after an injury
• You have belly pain or swelling that is getting worse
• You are worried about any bleeding and cannot get a same-day appointment with your usual doctor

Book a routine appointment if:

• You bruise easily and want to know why
• You have a family history of a bleeding disorder
• You take medicines that can increase bleeding risk and want a review
• You have a long-term liver or bowel condition and notice new symptoms
• You want advice about preventing falls or injuries

Diagnosis

A healthcare provider will ask about your symptoms, medical history, medicines, and any recent injury. They will examine you and may check your blood pressure, pulse, breathing, and belly. If internal bleeding is possible, they may send you to hospital for tests and monitoring. You do not need to work out the cause yourself; the care team will guide you.

Tests that may be done

• Blood tests to check your blood count, clotting, liver, and kidney function
• Stool or urine tests to look for blood
• Ultrasound, CT scan, or MRI to look inside the body
• Endoscopy or colonoscopy, where a thin camera checks the stomach or bowel
• Angiography, a scan that shows blood vessels and can sometimes help stop bleeding
• Monitoring of blood pressure, pulse, breathing, and oxygen levels

What to expect at your appointment

If internal bleeding is suspected, you may be seen quickly in an emergency department or urgent care setting. The team may start monitoring, give fluids through a drip, and arrange scans or camera tests. Some people need to stay in hospital for observation. The tests can feel busy or unsettling, but staff will explain each step and help you understand what is happening.

Treatment

Treatment aims to stop the bleeding, keep your body stable, and treat the cause. The right approach depends on where the bleeding is, how severe it is, and your overall health. Some people need only careful monitoring and follow-up, while others need hospital care or a procedure.

Self-care at home

• Do not ignore new bleeding or signs of blood loss; seek medical advice promptly.
• Follow your care team's advice about activity, rest, and follow-up appointments.
• Do not stop or change any prescribed medicine without speaking to your healthcare provider or pharmacist.
• Avoid alcohol while you are being assessed or recovering, unless your provider says it is safe.
• Keep a note of your symptoms, medicines, and questions so you can discuss them at your appointment.
• Ask for help with lifts, childcare, or daily tasks if you feel weak or are recovering from a procedure.

Medical treatments

Medical treatment may include close monitoring in hospital, fluids or blood products if needed, medicines that help blood clot or treat the underlying cause, and procedures to seal or repair bleeding blood vessels. Your care team will explain the options, benefits, and risks, and will ask for your consent before procedures. They will also review medicines that might increase bleeding risk.

When is surgery considered?

Surgery or a camera-guided procedure may be needed if bleeding does not stop, if an injury needs repair, or if a bleeding blood vessel or damaged organ needs treatment. The care team will explain why a procedure is recommended and what recovery may involve.

Living with this condition

Most people need follow-up after internal bleeding to check healing and treat the cause. Keep your appointments, take medicines exactly as prescribed, and know the warning signs that mean you should get urgent help. Ask your provider what level of activity is safe for you and when you can return to work, driving, or exercise.

Lifestyle tips

• Prevent falls by keeping pathways clear, using good lighting, and wearing safe footwear.
• Use seatbelts and protective gear for work, sport, or cycling.
• Eat regular balanced meals and drink enough fluids unless your provider advises otherwise.
• Limit alcohol and do not smoke, as these can affect liver health, blood vessels, and healing.
• Review all medicines, including over-the-counter painkillers and supplements, with a pharmacist or doctor.
• Manage long-term conditions such as liver disease or high blood pressure as advised.

Diet and exercise

A balanced diet with enough protein, vitamins, and minerals supports healing. If you lost blood, your provider may check your iron levels and discuss diet or supplements. Gentle activity, such as short walks, can help recovery once your care team says it is safe. Avoid heavy lifting, contact sports, or strenuous exercise until you are cleared, especially after an injury or procedure.

Mental health and emotional wellbeing

It is normal to feel anxious or shaken after internal bleeding, especially if it came on suddenly or needed hospital care. You may worry about it happening again or feel stressed about recovery. Talk to your healthcare provider about these feelings. If you feel unsafe, hopeless, or in crisis, contact your local emergency number or a local crisis support service right away.

Prevention

Not all internal bleeding can be prevented, but you can lower your risk. Prevent injuries, manage long-term conditions, review medicines that increase bleeding risk, and get help early for ulcers, liver problems, or unusual bleeding.

Vaccines

There is no vaccine for internal bleeding itself. Keep up with routine vaccines recommended for your age and health, because serious infections can sometimes affect blood vessels or organs.

Screening programmes

There is no single screening test for internal bleeding. Screening for related conditions, such as bowel cancer, liver disease, or high blood pressure, may be advised at certain ages or if you have risk factors. Ask your healthcare provider what screening is right for you.

Complications

If left untreated

• Shock, when blood loss causes dangerously low blood pressure
• Anemia from losing too much blood
• Damage to organs that do not get enough blood and oxygen
• Serious problems after a head injury or major trauma
• Death in severe cases if bleeding is not stopped quickly

Long-term outlook

The outlook depends on the cause, how quickly help is received, and your overall health. Many people recover well with prompt treatment and follow-up. If you have internal bleeding or are recovering from it, you are not alone, and your care team can help you understand what to expect and how to reduce the chance of problems.

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