What causes internal bleeding?

Internal bleeding can occur as a result of trauma or with a variety of medical conditions. The risk is increased with clotting abnormalities and anti-clotting medications.

Nontraumatic causes of internal bleeding

Although internal bleeding is often due to trauma, it may also be caused by a variety of conditions including:

  • Anticlotting medications
  • Arteriovenous malformation (abnormal connections between arteries and veins)
  • Gastritis (inflammation of the stomach lining)
  • Gastroenteritis (infection of the digestive tract)
  • Hemophilia (rare hereditary disorder in which blood does not clot normally)
  • Inflammatory bowel disease (includes Crohn’s disease and ulcerative colitis)
  • Liver disease (includes any type of liver problem, such as hepatitis, cirrhosis and liver failure)
  • Medication side effects, especially nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and indomethacin (Indocin)
  • Ruptured aneurysm (rupture of a weakened, bulging area of an artery)
  • Thrombocytopenia (low blood platelet count; platelets help form clots to stop blood loss)
  • Von Willebrand’s disease (hereditary bleeding disorder)

Serious or life-threatening causes of internal bleeding

In some cases, internal bleeding may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Bleeding esophageal varices (life-threatening rupture and hemorrhage of swollen veins in the esophagus)
  • Bowel infarction (severe bowel injury due to decreased blood supply)
  • Ectopic pregnancy (life-threatening pregnancy growing outside the uterus)
  • Head injury
  • Ruptured aortic aneurysm (rupture of a weakened, bulging area of the aorta)
  • Ruptured liver or spleen
  • Trauma, such as bone deformity, eye injuries, and other injuries

Questions for diagnosing the cause of internal bleeding

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your internal bleeding including:

  • When did you first notice your symptoms?
  • Have you been feeling tired or dizzy?
  • Have you noticed any blood in your stool or urine?
  • Have you been having any pain?
  • Do you have any other symptoms?
  • Do you have any preexisting health problems?
  • What medications are you taking?

What are the potential complications of internal bleeding?

Because internal bleeding can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Altered or decreased sensation
  • Anemia (low red blood cell count)
  • Brain damage
  • Organ failure
  • Paralysis or weakness (loss of strength)
  • Shock
  • Unconsciousness and coma


  1. Bleeding. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm.
  2. What is iron-deficiency anemia? National Heart Lung and Blood Institute Diseases and Conditions Index. http://www.nhlbi.nih.gov/health/dci/Diseases/ida/ida_diagnosis.html.

What is internal bleeding?

Internal bleeding is blood loss occurring within your body. Because it occurs inside your body, internal bleeding may go unnoticed initially. If the bleeding is rapid, enough blood may build up to press on internal structures or to form a bulge or discoloration under your skin. Severe internal bleeding can cause shock and loss of consciousness.

Symptoms vary based on the location ... Read more about internal bleedingintroduction


What other symptoms might occur with internal bleeding?

Symptoms accompanying internal bleeding vary based on the location and speed of blood loss. Pain may or may not be present. Rapid bleeding can quickly cause weakness, dizziness, shock and unconsciousness. Slower bleeding may ultimately cause anemia, with the gradual onset of tiredness, weakness, shortness of breath, and p... Read more about internal bleedingsymptoms

Medical Reviewer: William C. Lloyd III, MD, FACS Last Annual Review Date: Aug 23, 2013 Copyright: © Copyright 2014 Health Grades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Health Grades, Inc. Use of this information is governed by the HealthGrades User Agreement.

This Article is Filed Under: Heart, Blood and Circulation