The management of lower gastrointestinal hemorrhage.
OBJECTIVE
Gastrointestinal hemorrhage is a common clinical problem, which accounts for approximately 1 to 2 percent of acute hospital admissions. The colon is responsible for approximately 87 to 95 percent of all cases of lower gastrointestinal bleeding, with the remaining cases arising in the small bowel. The etiology, diagnostic evaluation, management, and treatment options available for lower gastrointestinal hemorrhage were reviewed.


METHODS
A review of lower gastrointestinal bleeding was performed, which discussed the most common etiologies with a few rare and unusual causes. The current literature about different diagnostic techniques, management problems, and therapeutic options was reviewed. Current management strategies and treatment options for the many causes of lower gastrointestinal bleeding will be reviewed.


RESULTS
A review of the different causes of lower gastrointestinal hemorrhage and available diagnostic studies was performed. Management strategies based on the etiology of the bleeding and results of the diagnostic studies were discussed. An algorithm was provided to develop a diagnostic and therapeutic treatment strategy for lower gastrointestinal hemorrhage.


CONCLUSIONS
Lower gastrointestinal hemorrhage can be a difficult and frustrating problem to both the clinician and the patient. Knowledge of the available diagnostic tests to help identify the source of bleeding is essential to the practicing clinician. Once the source is identified, management strategies and available treatment options need to be specific for each individual case. This review will aid the practicing physician in developing an algorithm for lower gastrointestinal hemorrhage.
Hoedema
Rebecca E
RE
Department of Colon and Rectal Surgery, The Ferguson Clinic, Grand Rapids, Michigan 49546, USA. rhoedema@hotmail.com
Luchtefeld
Martin A
MA
D000792:Angiography; D003108:Colonic Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D003113:Colonoscopy; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D011877:Radionuclide Imaging