Evaluation of the causes and outcome of lower gastrointestinal bleeding: An endoscopic study

Abstract

Introduction: Lower gastrointestinal bleeding (LGIB) is bleeding arising below the ligament of Treitz. The epidemiology of (LGIB) in western populations has been well documented in multiple studies, but there are scant reports about this condition in Egypt. We tried to through highlights on the causes and outcomes of such cases. Methods: This prospective study was conducted on all adult patients presented to the hepatology and Gastroentrology unit, specialized medical hospital, Mansoura Univ. with LGIB during the period from 1/1/2016 to 31/12/2016. The results: A total of 193 cases was included in the study consisting of 112 (58%) males and 81 (42%) females, with a median age of 43 years. Most patients were outpatients (116, 60%), or inpatients (68, 35%), while (9, 5%) were referred from other centers. the commonest comorbidities were hypertension (38, 19.7%) and diabetes mellitus (15, 7.8%). The commonest associated drug was anti-platelet (16, 8.3%). Cases were presented by hematochezia (172, 89.1%), iron deficiency anaemia (15, 7.8%), melena (3, 1.6%) and occult lower GIT bleeding (3, 1.6%). The most common causes were colorectal carcinoma (CRC) in 33 patients (17.1%), ulcerative colitis (UC) in 32 patients (16.6%), infectious colitis in 29 patients, (15%), piles in 29 patients (15%) and diverticulosis in 19 patients (9.8%). Only 2 patients were haemodynamically unstable and were candidates for urgent colonoscopy and 10 patients needed transfusion of packed red blood cells before intervention. 62 patients needed surgical consultation for their cause of bleeding. Conclusion: Our research showed that CRC, UC, infectious colitis, piles and diverticulosis were the most common causes of LGIB among our study cases, with men more predisposed to LGIB than women. These findings are broadly different from those reported in western populations.