Lower gastrointestinal bleeding occurs from any site distal to the ligament of Treitz and proximal to the anus, affecting areas such as the jejunum, ileum, colon, and rectum. Common causes include anal and rectal lesions, colonic lesions such as carcinoma or polyps, and small bowel issues like Meckel's diverticulum. Hematochezia, characterized by bright red blood per rectum, can indicate bleeding from the lower GI tract or rapid hemorrhage from the upper GI tract.

1. Etiology –lower GI bleed

2. Lower Gastrointestinal Bleed
 A lower Gastrointestinal Bleed is referred as
any bleed that occures distal to the
ligament of Treitz and superior to the anus.
This includes the last 1/4 of the duodenum
and the entire area of the jejunum, ileum,
colon, rectum, and anus

3. Lower Gastrointestinal Bleeding
 Lower GI bleeding originates in the
portions of the GI tract farther down the
digestive system—the segment of the
small intestine farther from the stomach,
large intestine, rectum, and anus.

4. Haematochezia
 Haematochezia (bright red blood per rectum)
 Source:distal to ligament of Treitz or rapid
haemorrhage into upper GItract
 Upper GI ( Haemodynamic instability+ drop in
Hb)

5. Anal and rectal lesions
 Hemorrhoids,fissure,fistula
 Proctitis
 Rectal trauma
 Carcinoma of rectum

7. Colonic lesions
 Carcinoma
 Polyp
 Vascular ectasia
 IBD
 Infectious colitis
 Ischemic colitis
 NSAID

9. Small Bowel
 Meckels diverticulum
 Intussception
 Mesenteric infarction
 Aortoenteric fistula

10. Upper GIT
 Massive hemorrhage
from a duodenal ulcer

11. Systemic diseases
 Coagulation disorders
 Uremia

12. Drugs
 Anticoagulants

13. Aetiology
carcinoma
polyps
Meckel’s diverticulum
angiodysplasia intussusception
enteritis colitis
carcinoma Crohn’s disease
Diverticular
disease
carcinoma
proctitis
haemorrhoids
solitary ulcer fissure
carcinoma
warts
Perianal Crohn’s disease

14. Hematochezia
GIT Systemic
upper lower
Massive Anorectal Bleeding disorder
haemorrhage Uremia
from Colon Drugs
Duodenal Aortoduodenal
ulcer.
Anticoagulant,
Small
Bleeding
Bowel
disorder