Lower Gastrointestinal Hemorrhage

What is lower gastrointestinal hemorrhage?

Lower gastrointestinal tract bleeding is a condition in which there is bleeding from the lower part of the digestive system, specifically the large bowel, the rectum or the anus. The main symptoms are either fresh red blood passed from the anus or maroon-colored bowel movements. Massive bleeding from the lower gastrointestinal tract is a medical emergency. Elderly people and people with a history of diverticular disease, inflammatory bowel disease and colon or rectum cancer develop this condition more commonly. The treatment depends upon the cause of the bleeding, but almost always includes replacement of fluid and blood and, if possible, finding the source and stopping the bleeding.

Risks

There are many possible causes for lower gastrointestinal tract bleeding. Conditions that cause small amounts of bleeding are hemorrhoids, anal fissures and some sexually transmitted diseases. Conditions which can cause larger bleeds are bowel cancers (cancer of the colon, rectum or anus), some bowel infections (such as food poisoning), diverticular disease, blood vessel malformations inside the bowel and inflammatory bowel diseases (ulcerative colitis and Crohn's disease). People who take medications to thin the blood have an increased risk of a large bleed from the bowel. Elderly people are more commonly affected by this condition than younger people.

Symptoms

The most common symptom is bright red blood passed from the anus or in the stool. Other symptoms may include abdominal pain, dizziness, a fast and pounding heart, weakness, confusion and collapse, depending upon how much blood is lost.

Diagnosis

Diagnosis of the cause of the bleeding is based upon a person's medical history, laboratory findings and looking inside the bowel via endoscopy (using a long flexible camera through the mouth or anus to look at the bowel). In severe cases of blood loss and emergency, the diagnostic evaluation is only done after the person has been resuscitated and the bleeding has been stopped.

Treatment

Treatment depends on the amount of blood loss and the cause of the bleed. The cause should be investigated and treated to avoid further bleeding. If there has been a small bleed, these can be managed with medical or endoscopic therapy. If there has been severe blood loss, treatment includes hospitalization and resuscitation of the affected person. This may require fluids through a drip or blood transfusions, in addition to monitoring of blood pressure, heart rate, etc. People who have large bleeds may need emergency surgery to find and treat the cause of the bleed.

Prevention

People who take medications to thin the blood and who have a risk of bleeding from the bowel should have their blood clotting times carefully monitored. Receiving early diagnosis and treatment for conditions that can cause bleeding from the bowel may help to prevent some cases of lower gastrointestinal tract bleeding.

Other names for lower gastrointestinal hemorrhage

  • large bowel bleeding
  • lower gastrointestinal bleeding
  • lower GI hemorrhage