The causes and management of lower GI bleeding: a study based on clinical observations at Hanyang University Hospital

During the period of the study, lower GI bleeding patients comprised a constant 1.6% of the total admitted patients at Hanyang University Hospital annually. There were no statistically significant changes according to year. The 970 cases were classified as follows: hemorrhoid and anal fissure 65.5%, malignant neoplasm 21.1% (rectal cancer 16.9%, sigmoid colon cancer 3.3%, anal cancer 0.9%), benign neoplasm 4.2%, ulcerative colitis 3.3%, infectious colitis 2.3%, ischemic colitis 1.8%, radiation colitis 1.3%, diverticulosis 0.3%, and others 0.2%. Ulcerative colitis and rectosigmoid cancer showed increasing trends, while other disease groups showed no change in the occurrence rate. Hemorrhoid and anal fissure developed mostly in the 30s age group, benign polyp and ulcerative colitis in the 40s age group, malignant neoplasm in the 50s age group, and ischemic colitis and radiation colitis in the 60s age group. There was no sexual predominance of lower GI bleeding. About 10% of the patients admitted to the hospital needed transfusions, particularly patients with ulcerative colitis (21.9%) and radiation colitis (23.1%). 20.2% of the patients improved with supportive measures and medical treatment and 79.8% underwent surgical operation. In particular, 51.2% of the patients with benign neoplasm underwent polypectomies.