Lower gastrointestinal bleeding (patient information)

Lower gastrointestinal bleeding
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
Diagnosis
When to seek urgent medical care?
Treatment options
Where to find medical care for Xyz?
Prevention
What to expect (Outlook/Prognosis)?
Possible complications
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Rectal bleeding can refer to any blood that passes from your anus, although rectal bleeding is usually assumed to refer to bleeding from your lower colon or rectum. Your rectum makes up the last few inches of your large intestine. Rectal bleeding may show up as blood in your stool, on the toilet paper or in the toilet bowl. Blood that results from rectal bleeding is usually bright red in color, but occasionally can be dark maroon.

What are the Symptoms of Lower gastrointestinal bleeding?

Symptoms of lower gastrointestinal bleeding include:

• Rectal bleeding
• Unexplained weight loss
• Change in bowel habit
• Pain during defecation
• Anal symptoms
  • Soreness or pain may occur with fissures, itching with piles.

What Causes Lower gastrointestinal bleeding ?

Common casues of lower gastrointestinal bleeding include:

• Haemorrhoids
• Anal fissure
• Fistula-in-ano
• Diverticular disease
• Crohn's disease
• Ulcerative colitis
• Colonic polyps
• Colorectal or anal cancer

Who is at Highest Risk?

Common risk factors in the development of lower GI bleeding include advancing age, previous history of gastrointestinal bleed, chronic constipation, hematologic disorders, anticoagulants medications, non-steroidal anti-inflammatory drugs, and human immunodeficiency virus infection.

Diagnosis

• Generally, people younger than 40 who whose rectal bleeding is from an obvious cause, such as hemorrhoids, don't need testing. However, many doctors recommend tests such as a colonoscopy for people older than 40 to rule out any possibility of also having cancer that's contributing to the bleeding. Which ones you have will depend on the type and the amount of bleeding you have experienced, as well as on your blood test results and medical history.
• Endoscopy
  • An endoscopy is an investigation that involves a long, thin camera. There are three different types of endoscopy that you may be referred for to investigate rectal bleeding.
• Oesophagogastricduodenoscopy (OGD)
  • This is where an endoscope camera is passed via your mouth into your stomach and small bowel to look for the cause of bleeding. Sedation is available, but not routinely required.
• Colonoscopy
  • This is where an endoscope camera is inserted via your anus into your rectum and around your colon to look for the cause of bleeding. You are usually sedated for this procedure.
• Flexible sigmoidoscopy
  • This is where a shorter endoscope camera is inserted via your anus into your rectum to your sigmoid colon to look for the cause of bleeding.

When to Seek Urgent Medical Care?

Seek urgent medical care if you have significant rectal bleeding and any signs of shock:

• Rapid, shallow breathing
• Dizziness or lightheadedness after standing up
• Blurred vision
• Fainting
• Confusion
• Nausea
• Cold, clammy, pale skin
• Low urine output

Treatment Options

The treatment for rectal bleeding depends on the cause and source of the bleeding. Regardless of the source of bleeding, treatment of significant blood loss will begin by stabilizing the patient's condition.

• Initially, oxygen will be provided to the patient and the heart will be monitored.
• An IV will be started to administer fluids and for a possible blood transfusion.
• Further treatment options will depend on the suspected source of bleeding.
• It is likely a specialist such as a general surgeon, gastroenterologist, or ulcerative colitis will become involved in the treatment plan.
• Admission to the hospital is required when a marked amount of blood loss has occurred, if bleeding has not stopped, or if your vital signs have not become normal.

Where to find Medical Care for Lower gastrointestinal bleeding?

Medical care for Lower gastrointestinal bleeding can be found here.

Prevention

Effective measures for the primary prevention of lower GI bleeding include techniques to prevent the related conditions. Promoting a healthy lifestyle by eating a healthy diet, exercising lightly, and avoiding alcohol and tobacco can reduce the risk associated conditions.

What to Expect (Outlook/Prognosis)?

Prognosis of lower gastrointestinal bleeding naturally depends on the cause, as well as other factors such as age and comorbidity. No individual feature or symptom associated with rectal bleeding is strongly predictive of the eventual cause being diagnosed as colorectal cancer. However, certain associated features do make this cause more likely. These include:

• Weight loss
• Age over 50
• Change in bowel habit
• Iron-deficiency anaemia
• Blood mixed with stool
• A strong family history of colorectal cancer

Possible Complications

Shock and anemia are the most common direct complications of LGIB.

Sources

https://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3Aproject=medlineplus&v%3Asources=medlineplus-bundle&query=rectal+bleeding&_ga=2.112997956.1931948587.1513306403-709952338.1513306403
https://www.mayoclinic.org/symptoms/rectal-bleeding/basics/definition/sym-20050740?p=1
https://patient.info/doctor/rectal-bleeding-in-adults