Clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage: a descriptive cross-sectional study

Abstract

Background: Most of the bleeding in the lower gastrointestinal tract are usually located in the rectum, colon and terminal ileum. Colonoscopy is an invasive procedure used for both diagnostic and therapeutic purposes for detection of lower gastrointestinal (GI) tract pathologies and haemorrhage.
 Aims and Objective: The purpose of the study was to understand the clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage.
 Materials and Methods: Seventy-two patients presenting with lower GI haemorrhage were included in the study. All patients underwent colonoscopy after achieving hemodynamic stability and bowel preparation. Clinical profile and colonoscopic findings were studied.
 Results: The common aetiologies of lower GI haemorrhage were haemorrhoids followed by nonspecific colitis, colorectal polyp and carcinoma of colon. Rectum followed by sigmoid harbored majority of pathologies that presented with lower GI haemorrhage.
 Conclusions: The diagnosis of the pathological lesion and management of underlying cause not only prevents another episode of lower GI haemorrhage but also help in reducing morbidity and mortality. Colonoscopy or at least sigmoidoscopy is strongly recommended for evaluation, diagnosis and management of lower GI haemorrhage.

Colonoscopy findings of lower gastrointestinal bleeding in a tertiary care hospital: a 5-year retrospective study

“…12 The mean age of presentation of LGIB was 59± 16.9 years in the western country. 13 7,14,15 Similar findings were observed in our neighbouring country. 16,17 This reflects the possibility of similar environmental risk factors and patterns of LGI disease prevailing within the country.…”

“…Similar diseases patterns were seen in other Nepalese study. 6,7 However, the main causes were colonic diverticula followed by inflammatory bowel disease, colorectal cancer, colonic polyps, angiodysplasias and post polypectomy bleeding in western countries. 18,19 The possible explanation of etiological differences could be variable environmental factors, lifestyle, dietary habits and longevity of population.…”

“…36% (Malla et al), 35% (Shrestha UK), 27.8% (Bhattarai, et al) and 13.4% (Chaudhary, et al). 6,7,14,15 These differences could be due to sample sizes and threshold of performing colonoscopy especially in patients with proctoscopic findings of haemorrhoids. The most common cause for bleeding in western population was diverticulosis.…”

“…It constituted 5.6% to 18.3% in other Nepalese study. 7,14 Colonoscopy is the choice of investigation for identification and getting biopsy in suspected colorectal cancer. Colorectal malignancy was observed in 4.2% (21).…”

“…5 Haemorrhoids, IBD and malignancy are common causes in Nepal. 6,7 Colonoscopy is the investigation of choice for diagnosis in patients with LGIB. The American Society of Gastrointestinal Endoscopy (ASGE) recommends colonoscopy in all patients with occult GI bleed, chronic intermittent scant hematochezia in patients greater than 50 years.…”