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Lower gastrointestinal bleeding

A M Vernava1, B A Moore, W E Longo

  • 1Section of Colon and Rectal Surgery, Saint Louis University School of Medicine, Missouri, USA.

Diseases of the Colon and Rectum
|July 1, 1997
PubMed
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Lower gastrointestinal bleeding is common, with diverticulosis being the most frequent cause. Colonoscopy is the preferred diagnostic and therapeutic tool for managing this condition effectively.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Diagnostic Imaging

Background:

  • Lower gastrointestinal bleeding presents a diagnostic challenge requiring a structured approach.
  • Technological advancements like colonoscopy and selective mesenteric angiography have improved evaluation and management.
  • An organized strategy is essential for successful diagnosis and treatment of lower GI hemorrhage.

Purpose of the Study:

  • To review existing literature on lower gastrointestinal bleeding.
  • To determine the optimal current methods for evaluating and managing lower GI hemorrhage.
  • To identify strategies that lead to the most successful patient outcomes.

Main Methods:

  • A comprehensive MEDLINE search was conducted to retrieve relevant English literature.

Related Experiment Videos

  • Data pertaining to lower gastrointestinal bleeding were systematically reviewed and analyzed.
  • The study focused on identifying current best practices in diagnosis and management.

    • Main Results:

    • Diverticulosis is the most common cause of lower GI bleeding, followed by inflammatory bowel disease, colonic neoplasia, anorectal disease, and arteriovenous malformations.
    • Colonoscopy has a high success rate (74-82%) in identifying bleeding sources in severe hematochezia.
    • Mesenteric angiography demonstrates variable sensitivity (42-86%) and is useful when colonoscopy is not feasible.

    Conclusions:

    • Lower gastrointestinal hemorrhage necessitates a disciplined and advanced evaluation for effective management.
    • Colonoscopy is the diagnostic procedure of choice due to its accuracy and therapeutic potential.
    • Targeted therapies, like segmental colonic resection for bleeding diverticulosis, yield the highest success rates and lowest morbidity.