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Spectrum of lower gastrointestinal hemorrhage: an endoscopic study of 166 patients
M K Goenka1, R Kochhar, S K Mehta
1Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh.
Insights
This study investigated lower gastrointestinal bleeding causes using colonoscopy. Idiopathic ulcerative colitis and acute colitis were the most common causes, differing from Western country findings.
Area of Science:
- Gastroenterology
- Endoscopy
- Hemorrhage research
Background:
- Lower gastrointestinal hemorrhage (LGIB) etiology varies geographically.
- Understanding regional LGIB causes is crucial for effective diagnosis and treatment.
Purpose of the Study:
- To determine the spectrum of lesions causing LGIB in our region.
- To evaluate the utility of endoscopic examination in diagnosing LGIB.
Main Methods:
- A prospective study of 166 patients with LGIB.
- Colonoscopy was utilized as the primary diagnostic investigation.
Main Results:
- Colonoscopy identified the source of bleeding in 84.9% of patients.
- The leading causes of LGIB were idiopathic ulcerative colitis (19.3%), acute colitis (12.0%), and colonic polyps (10.2%).
- Other significant causes included radiation colitis, solitary rectal ulcer, colonic carcinoma, colonic tuberculosis, and enteric fever.
Conclusions:
- Endoscopic examination is highly effective for evaluating LGIB.
- The primary causes of LGIB in this region differ significantly from those reported in Western countries.
Background:
The spectrum of lesions causing lower gastrointestinal hemorrhage shows marked geographic variation. The study was aimed to determine this spectrum in our region using endoscopic examination.
Methods:
166 patients presenting with lower gastrointestinal hemorrhage were investigated using colonoscopy as the first investigation.
Results:
Lesions responsible for bleeding could be identified in 141 patients (84.9%). In 25 patients (15.1%), the etiology of bleed could not be determined either because of failure to identify a lesion (10 patients) or because of an incomplete examination (15 patients). Major causes of lower gastrointestinal bleeding included idiopathic ulcerative colitis (19.3%), acute colitis (12.0%), colonic polyps (10.2%), radiation colitis (9.0%), solitary rectal ulcer (7.8%), colonic carcinoma (7.2%), colonic tuberculosis (4.2%) and enteric fever (3.0%).
Conclusion:
Endoscopic examination is very useful in evaluating patients with lower gastrointestinal hemorrhage. The predominant causes of lower gastrointestinal bleeding in our experience are different from those reported from western countries.