16 - Lower Gastrointestinal Bleeding

Abstract

Acute severe lower gastrointestinal (GI) bleeding is a common problem and frequent reason for hospitalization with associated morbidity and mortality. Colonoscopy is often performed for diagnosis and potential therapeutic intervention. However, the optimal timing of colonoscopy remains unclear at this time. Common etiologies of lower GI bleeding include diverticulosis, postpolypectomy bleeding, arteriovenous malformation, colitis, malignancy, and radiation proctitis. Endoscopy therapy for lower GI bleeding is usually successful through a combination of hemoclips, injection of epinephrine, or ablation and coagulation. In cases of endoscopic failure, angiography and embolization are alternate therapeutic options. Surgery to control bleeding is rarely required.