GI Bleed

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