A few weeks ago I had a bit of trouble with internal bleeding. I mentioned it to many people, as well as here and I had a resounding response from many areas. The response was two important questions:

• How did I know I was bleeding?

And more importantly:

• How did I know where I was bleeding?

So I thought, they are both very good questions. I want to answer them in a way that everyone can understand.

Internal Bleeding

Internal bleeding is when you are bleeding, losing blood, inside your body. The difference between this blood flow and the typical flow of blood that happens in your body is how and where it is occurring. Typically blood moves through your body through the capillaries and blood vessels. Capillaries are tiny blood vessels that enable this special red fluid to move into your muscles.

Your body 101

Blood is important as it takes the nutrients, proteins, oxygen and energy (warmth) to every part of your body, allowing it to stay fresh and alive. It also takes waste away. I know you may feel like this is a simple concept but just think about how every millimetre of your body needs heat, or cells to regenerate, or the food that keeps cells from dying. Waste buildup in cells is toxic.

Consider your skin. (Because you can see it.) Now think about pouring hydrochloric acid on it. Or tripping over and grazing your knee on the loose bitumen. Hard. What would happen if you didn’t wash and clean either of these, but left them to fester and dwell in their filth for a few days. Covered in plastic wrap so they couldn’t breathe and dry out in the clean air, rather breeding bacteria and more toxic baddies in the warmth.

When you injure yourself you bleed. When you injure yourself on your skin you can see it. You are aware of the tissue that is damaged, the extent to which the damage has occurred and it is easily accessible to reach and clean it. Inside your body, just as on the outside, your systems, organs, joints and muscles are all encased in tissue. While the tissue on the outside is dry and thus subtly hardened, the tissue on the inside is moist and that bit more tender. It is easier to tear or damage. Not to mention how much stuff is squashed into that vessel you call a body!

Ways you will discover the blood

There are only so many exit holes for your body. To be frank there are a noticeable amount more exit holes than entrance holes. Of course I refer to pores for the large total of exit holes, but the ways things can leave your body are your urinary tract or urethra, bowels or colon, mouth, nostrils, ears and tear ducts. To be honest, I think bleeding from some of the more obscure sites occurs due to some pretty random illnesses which I have no idea about. I will stick to the three main ways, much more obvious and regular ways, and even then I can only discuss them in my limited experience.

You may discover blood in these three ways:

• In your mouth-coughing or vomiting it up from deeper down your throat.
• In your urine-flowing out with your ‘number ones’ (wee)
• In your faeces-as you do ‘number twos’ (poo)

Sexy stuff hey!

How to confirm the origins of blood

Firstly, if you see it in the toilet you may not have much of a chance to consider where it came from. My suggestion is to hop foot it to the nearest fresh water supply and as quick as is possible, guzzle down a good 600ml to 800ml. If you are able you can also have a bit of a feel of your stomach before the fluid passes through you. If this is the case you want to find a clean flat even surface (like the ground) where you can lie on your back. Relax and allow the tension to ease out of your abdomen. Use a flat open palm and fingers to softly apply pressure to your abdomen. You are feeling from side to side between the hip bones, then in the space just above, up the sides of your torso to the floating ribs at the bottom of your rib cage and then again across the torso just below the rib cage.

DO NOT PRESS HARDER WHEN YOU FIND A SORE OR TENDER AREA. Just take note of the location of each tenderness, and what the pain feels like (sharp, stabbing, aching, hot, throbbing etc).

You need this very relevant information for the medical staff at the hospital.  BECAUSE YOU NEED TO SEEK MEDICAL ADVICE AS SOON AS POSSIBLE.

If you notice the blood in your mouth refkect on how it got there. If you have had a cold or flu, and have been coughing thick sputum up and your cough is hacking and present for longer than a day, well this is likely the cause of the bleeding BUT YOU STILL NEED TO SEEK MEDICAL ADVICE.

If it was in vomit or you have not been powering through a cold virus then it can either come from your lungs or your stomach. Vomit is more likely to come from the stomach and chunks of clotted blood are more often ‘gifts’ from the lungs. Unless you cough little flecks, which I suppose could be fresh lung blood.

EITHER WAY SEEK MEDICAL ADVICE, DO NOT ATTEMPT TO MANAGE A VEHICLE.

How to know how fresh it is

Simple blood knowledge. Fresh blood is fluid and red. Old blood is clotted and black, brown, dark red or purple.

If the blood is fresh in the mouth perhaps it will be tinged with orange if it is mixed with bile, which is yellow. Or else it will be that saucy scarlet colour. The one that inspired Snow White’s lips.

In urine fresh blood will leave the bowl looking like you have poured a certain amount of watery tomato pasata in with your urine. Not joking. For ladies, it shouldn’t leave a blood trail when you wipe, as a period would and it won’t be ‘clotty’ as a period can appear sometimes to be.

Fresh blood in faeces is harder. Because faeces is harder, if I may be so blunt. (Sorry ma and pa for my ‘crassness’.) If it is fresh you can often find it accompanied by softer stool. How soft, I cannot say. If the stool is uncomfortably hard and the blood is significantly fresh then I’d suggest introducing more leafy greens and fibre into the diet. (Just saying, the blood could well be from the ‘last strides’ of the digestive tract, which may mean there is little of it and it’s only really obvious when you wipe so just have a look!)

Not so fresh blood in your stool will be clotted and make the overall ‘ensemble’ look patchy and dark brown or black.

Have a guess where it came from

Now this is the part I’m a bit of a master amateur at. Where did it come from?

• Urine means kidneys, bladder or urinary tract. Waste management, fluid retention and the occasional sexual or sexuality concern
• Mouth is lungs or stomach. Respiratory system or digestive system.
• Faeces is digestive tract. Digestive system.

Did I mention the most important part about this information?

THIS IS NOT MEANT TO HELP YOU TREAT YOURSELF AT HOME AND AVOID A DOCTOR. THIS IS TO HELP YOU UNDERSTAND THAT NO INTERNAL BLEEDING IS OKAY.

This is so you can estimate whether it is safer for you to get a car ride to the nearest hospital or to call the ambulance. Whether you should have someone drive you or you could manage to get yourself there. Whether you should pack an overnight bag or just your phone charger and a book.

I am not a medical professional. I have not listed all the answers, causes or symptoms of internal bleeding. I am only listing what your response should be if you suddenly notice blood has come out of one of your orifices.

INTERNAL BLEEDING IS NOT A MATTER TO BE CONSIDERED LIGHTLY. IT NEEDS IMMEDIATE MEDICAL ATTENTION.

For more information please see below.
Mayo Clinic- blood in urine
Mayo Clinic-blood in stool
Health clinic-vomiting blood