The use of endoscopy has grown and now allows doctors not only to see bleeding sites but to directly apply therapy as well. A variety of endoscopic therapies are useful to the patient for treating GI tract bleeding.

Active bleeding from the upper GI tract can often be controlled by injecting chemicals directly into a bleeding site with a needle introduced through the endoscope. A physician can also cauterize, or heat treat, a bleeding site and surrounding tissue with a heater probe or electrocoagulation device passed through the endoscope. Laser therapy, although effective, is no longer used regularly by many physicians because it is expensive and cumbersome.

Once bleeding is controlled, medicines are often prescribed to prevent recurrence of bleeding. Medical treatment of ulcers to ensure healing and maintenance therapy to prevent ulcer recurrence can also lessen the chance of recurrent bleeding. Studies are now under way to see if elimination of Helicobacter pylori affects the recurrence of ulcer bleeding.

Removal of polyps with an endoscope can control bleeding from colon polyps. Removal of hemorrhoids by banding or various heat or electrical devices is effective in patients who suffer hemorrhoidal bleeding on a recurrent basis. Endoscopic injection or cautery can be used to treat bleeding sites throughout the lower intestinal tract.

Endoscopic techniques do not always control bleeding. Sometimes angiography may be used. However, surgery is often needed to control active, severe, or recurrent bleeding when endoscopy is not successful.