Journal of Gastroenterology and Digestive Diseases

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.
Reach Us +1 (629)348-3199

Short Communication - Journal of Gastroenterology and Digestive Diseases (2024) Volume 9, Issue 2

Lower gastrointestinal bleeding: Detection and treatment

Ari Jang *

Department of Colorectal Surgery, University Hospital Tallaght, Ireland

*Corresponding Author:
Ari Jang
Department of Colorectal Surgery, University Hospital Tallaght, Ireland

Received: 23-Feb-2024, Manuscript No. JGDD-24-136136; Editor assigned: 24-Feb-2024, PreQC No. JGDD-24-136136(PQ); Reviewed: 09-Mar-2024, QC No. JGDD-24-136136; Revised: 14-Mar-2024, Manuscript No. JGDD-24-136136(R); Published: 21-Mar-2024, DOI: 10.35841/jgdd -9.2.194

Citation: : Jang A. Lower gastrointestinal bleeding: Detection and treatment. J Gastroenterol Dig Dis.2024;9(2):194

Visit for more related articles at Journal of Gastroenterology and Digestive Diseases


Lower gastrointestinal bleeding (LGIB) refers to bleeding originating from the small intestine (distal to the ligament of Treitz), colon, rectum, or anus. It is a common medical condition that can range from mild to life-threatening. This article explores the causes, detection methods, and treatment strategies for LGIB, providing a comprehensive overview for healthcare providers and patients [1].

Understanding the common causes of LGIB is crucial for effective diagnosis and treatment: Diverticulosis: The most common cause of LGIB, diverticulosis involves the formation of small pouches (diverticula) in the colon wall, which can bleed. Angiodysplasia: Abnormal, fragile blood vessels in the GI tract, often seen in the elderly, that can cause intermittent bleeding [2].

Inflammatory Bowel Disease (IBD): Conditions such as Crohn's disease and ulcerative colitis that cause chronic inflammation and ulceration of the intestinal lining. Colorectal Cancer: Tumors in the colon or rectum that can erode blood vessels and cause bleeding. Hemorrhoids: Swollen veins in the rectum or anus that can bleed, especially during bowel movements [3].

Ischemic Colitis: Reduced blood flow to the colon, leading to inflammation and bleeding, often associated with cardiovascular diseases. Infectious Colitis: Inflammation of the colon caused by infections, leading to bloody diarrhea. Radiation Proctitis: Inflammation and bleeding of the rectum due to radiation therapy, often seen in patients treated for pelvic cancers [4].

Detection Methods for Lower Gastrointestinal Bleeding: Accurate detection of the source and cause of LGIB is essential for effective management. The diagnostic approach includes a combination of history, physical examination, laboratory tests, and imaging studies [5].

Laboratory Tests: Complete Blood Count (CBC): To assess the severity of anemia and platelet count. Coagulation Profile: To evaluate for coagulopathies that might contribute to bleeding. Stool Tests: To detect occult blood and identify infectious agents [6].

Endoscopic Procedures: Colonoscopy: The primary diagnostic tool for LGIB, allowing direct visualization of the colon and rectum. It can identify and treat sources of bleeding such as diverticula, angiodysplasia, polyps, and tumors. Flexible Sigmoidoscopy: Useful for evaluating bleeding from the distal colon and rectum, particularly in stable patients with minor bleeding. Capsule Endoscopy: Used for detecting bleeding sources in the small intestine when colonoscopy is negative [7].

Imaging Studies: CT Angiography: A non-invasive imaging technique that can detect active bleeding and help localize the bleeding site. Radionuclide Scintigraphy: A nuclear medicine scan that detects bleeding by tracking radiolabeled red blood cells. Mesenteric Angiography: An invasive procedure used to localize and treat active bleeding by embolization [8].

Initial Stabilization: Intravenous Access and Fluid Resuscitation: Establish large-bore IV access and administer crystalloid fluids to maintain blood pressure and perfusion. Blood Transfusion: Transfuse packed red blood cells (PRBCs) as needed based on the severity of anemia and hemodynamic status. Endoscopic Therapy: Hemostasis Techniques: During colonoscopy, various techniques can be used to control bleeding, including injection of epinephrine, thermal coagulation, and mechanical methods such as clipping [9].

Polypectomy: Removal of bleeding polyps during colonoscopy to prevent further bleeding and potential malignant transformation. Pharmacologic Therapy: Vasoconstrictors: Drugs such as octreotide may be used in cases of bleeding due to angiodysplasia. Antibiotics: In cases of infectious colitis, appropriate antibiotics are administered based on the identified pathogen [10].


Lower gastrointestinal bleeding is a complex condition that requires a systematic approach for effective detection and treatment. Understanding the common causes and utilizing appropriate diagnostic tools, such as colonoscopy and CT angiography, are crucial for accurate identification of the bleeding source. Initial stabilization, including fluid resuscitation and blood transfusions, is essential for managing hemodynamically unstable patients. Endoscopic and angiographic therapies play significant roles in controlling active bleeding, while surgical intervention may be necessary in refractory cases.


  1. Kröner PT, Engels MM, Glicksberg BS, et al. Artificial intelligence in gastroenterology: A state-of-the-art review. World J Gastroenterol. 2021;27(40):6794.
  2. Indexed at, Google Scholar, Cross Ref

  3. Murphy B, Winter DC, Kavanagh DO. Small bowel gastrointestinal bleeding diagnosis and management—a narrative review. Front Surg. 2019;6:25.
  4. Indexed at, Google Scholar, Cross Ref

  5. Beck KR, Shergill AK. Colonoscopy in acute lower gastrointestinal bleeding: diagnosis, timing, and bowel preparation. Gastrointest Endosc Clin N Am. 2018;28(3):379-90.
  6. Indexed at, Google Scholar, Cross Ref

  7. Ierardi AM, Urbano J, De Marchi G, et al. New advances in lower gastrointestinal bleeding management with embolotherapy. Br J Radiol. 2016;89(1061):20150934.
  8. Indexed at, Google Scholar, Cross Ref

  9. Barnert J, Messmann H. Diagnosis and management of lower gastrointestinal bleeding. Nat Rev Gastroenterol Hepatol. 2009;6(11):637-46.
  10. Indexed at, Google Scholar, Cross Ref

  11. Sengupta N. The role of colonoscopy and endotherapy in the management of lower gastrointestinal bleeding. Best Pract Res Clin Gastroenterol. 2019;42:101615.
  12. Indexed at, Google Scholar, Cross Ref

  13. Ingason AB, Hreinsson JP, Björnsson ES. Gastrointestinal bleeding on oral anticoagulation: what is currently known. Drug Saf. 2022;45(12):1449-56.
  14. Indexed at, Google Scholar, Cross Ref

  15. Seth A, Khan MA, Nollan R, et al. Does urgent colonoscopy improve outcomes in the management of lower gastrointestinal bleeding?. Am J Med Sci. 2017;353(3):298-306.
  16. Indexed at, Google Scholar, Cross Ref

  17. Tanabe S. Diagnosis of obscure gastrointestinal bleeding. Clin Endosc. 2016;49(6):539.
  18. Indexed at, Google Scholar, Cross Ref

  19. Tonolini M, Bianco R. Acute HIV-related gastrointestinal disorders and complications in the antiretroviral era: spectrum of cross-sectional imaging findings. Abdom Imaging. 2013;38:994-1004.
  20. Indexed at, Google Scholar, Cross Ref

Get the App