Changes in Lower Gastrointestinal Bleeding Presentation, Management, and Outcomes Over a 10-Year Span

Area of Science:

• Gastroenterology
• Internal Medicine
• Clinical Outcomes Research

Background:

• Limited data exist on trends in lower gastrointestinal bleeding (LGIB) over the past decade.
• Changes in etiology, management, and patient outcomes require investigation.

Purpose of the Study:

• To compare LGIB patient characteristics, diagnostic approaches, and outcomes between two distinct time periods.
• To identify shifts in the causes and management of LGIB.

Main Methods:

• A comparative study of 301 patients from 2005-2007 and 249 patients from 2015-2017 hospitalized with LGIB.
• Analysis included patient comorbidities, diagnostic tool utilization (CT angiography, capsule endoscopy), bleeding etiology, and treatment outcomes.

Main Results:

• Patients in 2015-2017 had higher comorbidity scores and increased use of CT angiography and capsule endoscopy.
• Diverticular bleeding became the most common cause, replacing ischemic colitis; small bowel bleeding sources were more frequently confirmed.
• The 2015-2017 cohort experienced higher rebleeding rates, longer hospitalizations, and a greater need for blood transfusions.

Conclusions:

• LGIB patients hospitalized over the decade showed increased comorbidities.
• Diagnostic evaluation saw a significant rise in CT angiography and capsule endoscopy use.
• Longer hospital stays and increased transfusions suggest management of sicker LGIB patients.