Lower Gastrointestinal Bleeding
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Date
2013-12-09
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Abstract
The management of gastrointestinal bleeding poses the principal challenge of location of source of the bleeding, since some upper gastrointestinal (UGIB) sources occasionally present with features indistinguishable from lower gastrointestinal bleeding (LGIB).1,2 Recent advances in endoscopic procedures, in particular, increasing use of capsule endoscopy, have prompted some rethinking of the dichotomous classification with a proposal for upper, mid and lower catagories.1,2
In most parts of the world mid and lower source of bleeding account for 25-30 percent of GI bleeding 3,4 and since 80 percent of these forms of GI bleeding settle spontaneously within 24 hours, it seemed essential to ascertain the features of LGIB in our practice and determine how these affect management.
Six hundred and seventy-five patients who were referred from the surgical and medical out patients and general services for endoscopy for the two year period October 2010 to September 2012 were analysed retrospectively. The findings indicate that LGIB is not only less frequently encountered but also presents a less dramatic picture than UGIB. Haemorrhoids are the commonest cause (70.2 per cent), but increasingly significant are amoebic granulomas (7.0 percent) Diverticular disease (5.9 per cent) and Colo-rectal carcinoma (7.0 per cent).