What Are Signs of Internal Bleeding?

Key Takeaways

Internal bleeding can occur due to several incidences, such as trauma from an accident, gunshot or puncture wounds, or traumatic brain injury. It can also be caused by complications from surgery or childbirth, ectopic pregnancy, cancer, or gastrointestinal tract disorders.
The signs of internal bleeding are dizziness, drowsiness, cold sweat, pale and clammy skin, severe weakness, lack of energy, fainting, low blood pressure, vision problems, headache, confusion, fast breathing, fast heartbeat, chest pain, abdominal pain, nausea, and vomiting.
Internal bleeding is treated based on the source and severity of the bleeding. For minor internal bleeding, treatment may consist of rest, intravenous fluids, and symptom control measures. For more severe internal bleeding, emergency surgery or a blood transfusion may be necessary.

Bleeding or loss of blood occurs when there is a breach in a blood vessel anywhere in the circulatory system. This is called a hemorrhage. It can happen inside or outside the body. External bleeding is easy to recognize because you can see the blood flow, for example, from puncture wounds in the skin or a natural opening in the body such as the ears, nose, mouth, vagina, or rectum. Internal bleeding can be much more difficult to identify because it occurs due to a break in the blood vessels inside the body. However, because internal bleeding can quickly become life-threatening, it requires immediate medical attention. Please continue reading to find out some of the signs and symptoms of internal bleeding.

What are the causes of internal bleeding?

Internal bleeding commonly occurs due to:

Trauma (broken bones, traumatic brain injury, gunshot injuries, stab wounds, blunt trauma, physical abuse, car accidents)
Conditions of the gastrointestinal tract (for example, inflammation in the digestive tract (esophagitis, gastritis, colitis), peptic ulcer disease, Crohn’s disease)
Chronic high blood pressure (internal bleeding occurs due to weakening of the blood vessel walls)
Complications of surgery or medical procedures, such as childbirth
Medical conditions such as a burst aneurysm or ectopic pregnancy
Disorders of blood clotting factors
Hereditary bleeding disorders (for example, hemophilia) which can cause spontaneous bleeding
Damage to internal organs
Cancer
Infections (for example, viral hemorrhagic fevers like dengue, ebola, yellow fever)
Long-term and heavy alcohol, drug, or tobacco use

Risk factors for internal bleeding also include the use of certain medications, such as blood thinners.

What are the signs of severe internal bleeding?

The signs and symptoms of severe bleeding can include dizziness, drowsiness, cold sweat, pale and clammy skin, severe weakness, lack of energy, fainting, low blood pressure, vision problems, headache, confusion, fast breathing, fast heartbeat, chest pain, abdominal pain, nausea, and vomiting.

The signs of internal bleeding can vary depending on the location of the bleed:

Head

Intracranial hemorrhage (internal bleeding in the head) can cause sudden severe headache, weakness and numbness on one side of the body, tingling in the hands and feet, changes in vision or hearing, bleeding from the ears, nose, or mouth, loss of balance and coordination, difficulty speaking or understanding speech, reduced alertness, sleepiness, lethargy, and loss of consciousness.

Chest or Abdomen

Internal bleeding in the chest or abdomen can cause abdominal pain, swelling or tightness of the abdomen, nausea, vomiting including coffee grounds vomit, chest pain, shortness of breath, difficulty breathing, dizziness (especially when going from a lying or sitting position to a standing position), bruising around the navel or along the sides of the trunk, blood in the urine, black, tarry stools, and bleeding from the rectum.

Joints and Muscles

Internal bleeding in the joints and muscles can cause pain, swelling, and decreased range of motion.

Can you be bleeding internally and not know it?

Yes, you can be bleeding internally and not know it. The blood loss from an internal injury can remain contained within the body, for example, in the chest cavity, abdominal cavity, or skull. The symptoms depend on the severity of the injury. As a result, internal bleeding can occur for hours without you knowing it.

How long can you internally bleed without knowing?

How long you can internally bleed without knowing depends on many factors. In some cases, the internal bleeding is slow and silent because the blood loss is not significant enough to cause symptoms. Symptoms develop only after the bleeding continues for a few hours. In other cases, there is massive blood loss that is sudden and rapid, and it causes severe symptoms of internal bleeding. Even small internal hemorrhages can quickly become life-threatening and cause death within hours if they are not treated.

Can internal bleeding heal on its own?

Sometimes, internal bleeding due to minor injuries may stop on its own. However, there is no way to tell if you have severe internal bleeding without a physical exam, lab tests, and a thorough medical evaluation. You should not assume that your symptoms will go away on their own. It’s important to get immediate medical attention and have internal bleeding diagnosed and treated.

What are two ways to tell if bleeding is life-threatening?

You can tell that external bleeding is life-threatening by the presence of excess blood, such as blood spurting out of a wound, soaking the person’s clothes, or pooling on the ground. However, it can be impossible to tell when internal bleeding is a medical emergency without an assessment by healthcare providers.

What happens if internal bleeding is not treated?

Without treatment, internal bleeding can lead to organ damage and organ failure due to a lack of enough blood supply. It can even lead to coma and death. Even with treatment, severe internal bleeding is sometimes fatal.

How do doctors diagnose internal bleeding?

Doctors diagnose internal bleeding based on the medical history, a thorough physical examination, imaging tests such as CT scan, and in some cases, angiography to look at individual blood vessels that may be the bleeding source.

What is the treatment for internal bleeding?

The treatment for internal bleeding depends on the source of the bleeding and the severity. For minor internal bleeding, treatment may consist of rest, intravenous fluids, and symptom control measures. For more severe internal bleeding, a blood transfusion may be necessary to replace the blood loss. Sometimes, emergency surgery is needed to stop bleeding and clear any pooled blood from inside the body.

What to do if you suspect someone has internal bleeding?

If you suspect someone has symptoms of internal bleeding, do the following:

Before approaching the person, check for signs of danger. You cannot help someone if you become injured.
Call 911 or your local emergency services number.
Check if the person is conscious. If the person is unconscious, check for a pulse and breathing and start cardiopulmonary resuscitation (CPR), if necessary.
Offer reassurance if the person is conscious.
Lay the person down and keep them warm with a blanket or jacket.
If there is external bleeding and it appears to be a minor injury, apply direct pressure until the bleeding stops. But be careful not to cause further injury when applying direct pressure.
If possible, raise the person’s legs above the level of their heart.
Don’t give them anything to eat or drink.