Evaluation and management of lower gastrointestinal bleeding

Dis Mon. 2018 Jul;64(7):321-332. doi: 10.1016/j.disamonth.2018.02.002. Epub 2018 Mar 7.

Abstract

Lower gastrointestinal bleeding (LGIB) is a common cause of presentation to the emergency department and hospital admissions. The incidence of LGIB increases with age and the most common etiologies are diverticulosis, angiodysplasia, malignancy and anorectal diseases. Foremost modality for evaluation and treatment of LGIB is colonosopy. Other diagnostic tools such as nuclear scintigraphy, computed tomography, angiography and capsule endoscopy are also frequently used in the workup of LGIB. Choice of treatment modality depends on the hemodynamic status of the patient, rate of bleeding, expertise and available resources. We present a comprehensive review of the evaluation and management of LGIB.

Keywords: Diverticular bleeding; Diverticulosis; Hematochezia; Lower gastrointestinal bleeding.

Publication types

  • Review

MeSH terms

  • Angiodysplasia / complications
  • Angiography / methods
  • Anticoagulants* / therapeutic use
  • Capsule Endoscopy / methods
  • Colonoscopy* / methods
  • Diverticulum / complications
  • Embolization, Therapeutic / methods
  • Emergencies
  • Gastrointestinal Hemorrhage* / diagnosis
  • Gastrointestinal Hemorrhage* / etiology
  • Gastrointestinal Hemorrhage* / therapy
  • Gastrointestinal Neoplasms / complications
  • Hemostasis, Endoscopic* / methods
  • Humans
  • Resuscitation / methods
  • Risk Factors
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Anticoagulants