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Lower GI Bleeding: Epidemiology and Diagnosis

  • Lisa L. Strate
    Correspondence
    Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
    Affiliations
    Harvard Medical School, Boston, MA 02115, USA

    Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
    Search for articles by this author
      Lower gastrointestinal bleeding (LGIB) is anatomically defined as bleeding beyond the ligament of Treitz. The term “lower gastrointestinal bleeding” is therefore a misnomer, and a more appropriate term would be lower intestinal bleeding. Clinically, LGIB represents a diverse range of bleeding sources and severities, ranging from scant hemorrhoidal bleeding to massive blood loss from vascular small bowel tumors. Various terms are used to describe blood emanating from the lower intestinal tract, including hematochezia, rectal bleeding, and bright red blood per rectum. These terms do not indicate the acuity or severity of bleeding, do not always localize the bleeding source, and are not exclusive to bleeding from beyond the ligament of Treitz. The wide clinical spectrum of LGIB and the number of available management strategies present a challenge for clinicians and investigators both. This review focuses on the epidemiology and diagnosis of acute LGIB with an emphasis on bleeding from colonic sources.
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