Acute lower gastrointestinal bleeding refers to recent blood loss originating from the colon. Common causes include diverticulosis, angiodysplasia, inflammatory bowel disease, and neoplasms. Symptoms include the passage of maroon or bright red blood or blood clots from the rectum, with blood from the left colon appearing bright red and blood from the right colon appearing dark or mixed with stool. Colonoscopy is recommended for patients presenting with hematochezia who are hemodynamically stable to identify the source of bleeding and guide specific treatments.

1. Lower GI bleeding
Dr Sunil Thomas George

2. Introduction
 Acute lower gastrointestinal (GI) bleeding refers to blood loss of recent onset originating from the
colon.

3. Causes
 GI bleeding may be grouped into several categories:
1. Anatomic (diverticulosis)
2. Vascular (angiodysplasia, ischemic, radiation-induced)
3. Inflammatory (infectious, inflammatory bowel disease)
4. Neoplastic
 In addition, acute lower GI bleeding can occur after therapeutic interventions such as
polypectomy.

4. Features
 Hematochezia (passage of maroon or bright red blood or blood clots per rectum).
 Blood originating from the left colon tends to be bright red in color
 Bleeding from the right side of the colon usually appears dark or maroon colored and may be
mixed with stool.
 Rarely, bleeding from the right side of the colon will present with melena.

5. Approach

6. Hematochezia
Hemodynamicall
y stable
Colonoscopy
Source identified
?

7. YES? No?
Specific
treatment
Was the episode
isolated,self limited
and not associated
with IDA