Your doctor will take a medical history, including a history of previous bleeding, conduct a physical exam and possibly order tests. Tests might include:
- Blood tests. You may need a complete blood count, a test to see how fast your blood clots, a platelet count and liver function tests.
- Stool tests. Analyzing your stool can help determine the cause of occult bleeding.
- Nasogastric lavage. A tube is passed through your nose into your stomach to remove your stomach contents. This might help determine the source of your bleed.
- Upper endoscopy. This procedure uses a tiny camera on the end of a long tube, which is passed through your mouth to enable your doctor to examine your upper gastrointestinal tract.
- Colonoscopy. This procedure uses a tiny camera on the end of a long tube, which is passed through your rectum to enable your doctor to examine your large intestine and rectum.
- Capsule endoscopy. In this procedure, you swallow a vitamin-size capsule with a tiny camera inside. The capsule travels through your digestive tract taking thousands of pictures that are sent to a recorder you wear on a belt around your waist. This enables your doctor to see inside your small intestine.
- Flexible sigmoidoscopy. A tube with a light and camera is placed in your rectum to look at your rectum and the last part of the large intestine that leads to your rectum (sigmoid colon).
- Balloon-assisted enteroscopy. A specialized scope inspects parts of your small intestine that other tests using an endoscope can’t reach. Sometimes, the source of bleeding can be controlled or treated during this test.
- Angiography. A contrast dye is injected into an artery, and a series of X-rays are taken to look for and treat bleeding vessels or other abnormalities.
- Imaging tests. A variety of other imaging tests, such as an abdominal CT scan, might be used to find the source of the bleed.