Lower gastrointestinal bleeding

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Lower gastrointestinal bleeding
Synonyms	LGIB
Pronounce	N/A
Specialty	N/A
Symptoms	Hematochezia, melena, anemia, abdominal pain
Complications	Hypovolemic shock, iron deficiency anemia
Onset	Sudden or gradual
Duration	Variable
Types	N/A
Causes	Diverticulosis, angiodysplasia, colorectal cancer, inflammatory bowel disease, hemorrhoids
Risks	Age, anticoagulant use, NSAID use, history of gastrointestinal disease
Diagnosis	Colonoscopy, CT angiography, fecal occult blood test
Differential diagnosis	Upper gastrointestinal bleeding, anal fissure, peptic ulcer disease
Prevention	N/A
Treatment	Endoscopy, angiographic embolization, surgery, blood transfusion
Medication	Proton pump inhibitors, octreotide, antibiotics
Prognosis	Depends on cause and severity
Frequency	Common, especially in older adults
Deaths	N/A

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Diverticulosis

Algorithm for lower GI bleed

Lower gastrointestinal bleeding ('LGIB) is a common medical condition that involves bleeding in the lower gastrointestinal tract. The lower gastrointestinal tract includes the large intestine, rectum, and anus. LGIB can be acute or chronic, and its severity can range from mild to life-threatening.

Causes

The most common causes of LGIB include diverticular disease, angiodysplasia, colitis, anal fissures, and hemorrhoids. Less common causes include colorectal cancer, inflammatory bowel disease, and ischemic colitis. Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and anticoagulants, can also increase the risk of LGIB.

Symptoms

The primary symptom of LGIB is the passage of red or maroon-colored blood from the rectum. The blood may be mixed with stool or form clots. Other symptoms can include abdominal pain, anemia due to blood loss, and signs of shock in severe cases.

Diagnosis

Diagnosis of LGIB typically involves a combination of medical history, physical examination, and diagnostic tests. These tests can include colonoscopy, computed tomography (CT) scan, and angiography. In some cases, a capsule endoscopy or double-balloon enteroscopy may be used.

Treatment

Treatment for LGIB depends on the cause and severity of the bleeding. Initial treatment often involves fluid resuscitation to replace lost blood. Medications may be used to stop the bleeding or reduce the risk of further bleeding. In severe cases, surgery may be required.

See also

• Upper gastrointestinal bleeding
• Gastrointestinal bleeding
• Gastroenterology

References

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