Lower Gastrointestinal Bleeding Research Paper
Lower Gastrointestinal Bleeding
Lower gastrointestinal (GI) bleeding is the result of bleeding from the colon, rectum, or anal area. The colon is the last part of the digestive tract, where stool (feces) is formed. If you have lower GI bleeding, you may see blood in or on your stool. It may be bright red.
Lower GI bleeding often stops without treatment. Continued or heavy bleeding needs emergency treatment at the hospital.
WHAT ARE THE CAUSES?
Lower GI bleeding may be caused by:
• A condition that causes pouches to form in the colon over time (diverticulosis).
• Swelling and irritation (inflammation) in areas with diverticulosis (diverticulitis).
• Inflammation of the colon (inflammatory bowel disease).
• Swollen veins in the rectum
(hemorrhoids).
• Painful tears in the anus (anal fissures), often caused by passing hard stools.
• Cancer of the colon or rectum.
• Noncancerous growths (polyps) of the colon or rectum.
• A bleeding disorder that impairs the formation of blood clots and causes easy bleeding (coagulopathy).
• An abnormal weakening of a blood vessel where an artery and a vein come together (arteriovenous malformation).
WHAT INCREASES THE RISK?
You are more likely to develop this condition if:
• You are older than 60 years of age.
• You take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) on a regular basis.
• You take anticoagulant or antiplatelet drugs.
• You have a history of high-dose X-ray treatment (radiation therapy) of the colon.
• You recently had a colon polyp removed.
WHAT ARE THE SIGNS OR SYMPTOMS?
Symptoms of this condition include:
• Bright red blood or blood clots coming from your rectum.
• Bloody stools.
• Black or maroon-colored stools.
• Pain or cramping in the abdomen.
• Weakness or dizziness.
• Racing heartbeat.
HOW IS THIS DIAGNOSED?
This condition may be diagnosed based on:
• Your symptoms and medical history.
• A physical exam. During the exam, your health care provider will check for signs of blood loss, such as low blood pressure and a rapid pulse.
• Tests, such as:
○ Flexible sigmoidoscopy. In this procedure, a flexible tube with a camera on the end is used to examine your anus and the first part of your colon to look for the source of bleeding.
○ Colonoscopy. This is similar to a flexible sigmoidoscopy, but the camera can extend all the way to the uppermost part of your colon.
○ Blood tests to measure your red blood cell count and to check for coagulopathy.
○ An imaging study of your colon to look for a bleeding site. In some cases, you may have X-rays taken after a dye or radioactive substance is injected into your bloodstream (angiogram).
HOW IS THIS TREATED?
Treatment for this condition depends on the cause of the bleeding. Heavy or persistent bleeding is treated at the hospital. Treatment may include:
• Getting fluids through an IV tube inserted into one of your veins.
• Getting blood through an IV tube (blood transfusion).
• Stopping bleeding through high-heat coagulation, injections of certain medicines, or applying surgical clips. This can all be done during a colonoscopy.
• Having a procedure that involves using a long, thin tube to inject a material in a blood vessel to block blood flow to the bleeding site (angiogram and embolization).
• Stopping some of your regular medicines for a certain amount of time.
• Having surgery to remove part of the colon. This may be needed if bleeding is severe and does not respond to other treatment.
FOLLOW THESE INSTRUCTIONS AT HOME:
• Take over-the-counter and prescription medicines only as told by your health care provider. You may need to avoid aspirin, NSAIDs, or other medicines that increase bleeding.
• Eat foods that are high in fiber. This will help keep your stools soft. These foods include whole grains, legumes, fruits, and vegetables. Eating 1–3 prunes each day works well for many people.
• Drink enough fluid to keep your urine clear or pale yellow.
• Keep all follow-up visits as told by your health care provider. This is important.
CONTACT A HEALTH CARE PROVIDER IF:
• Your symptoms do not improve.
GET HELP RIGHT AWAY IF:
• Your bleeding increases.
• You feel light-headed or you faint.
• You feel weak.
• You have severe cramps in your back or abdomen.
• You pass large blood clots in your stool.
• Your symptoms get worse.
Lower gastrointestinal (GI) bleeding is the result of bleeding from the colon, rectum, or anal area. The colon is the last part of the digestive tract, where stool (feces) is formed. If you have lower GI bleeding, you may see blood in or on your stool. It may be bright red.
Lower GI bleeding often stops without treatment. Continued or heavy bleeding needs emergency treatment at the hospital.
WHAT ARE THE CAUSES?
Lower GI bleeding may be caused by:
• A condition that causes pouches to form in the colon over time (diverticulosis).
• Swelling and irritation (inflammation) in areas with diverticulosis (diverticulitis).
• Inflammation of the colon (inflammatory bowel disease).
• Swollen veins in the rectum
(hemorrhoids).
• Painful tears in the anus (anal fissures), often caused by passing hard stools.
• Cancer of the colon or rectum.
• Noncancerous growths (polyps) of the colon or rectum.
• A bleeding disorder that impairs the formation of blood clots and causes easy bleeding (coagulopathy).
• An abnormal weakening of a blood vessel where an artery and a vein come together (arteriovenous malformation).
WHAT INCREASES THE RISK?
You are more likely to develop this condition if:
• You are older than 60 years of age.
• You take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) on a regular basis.
• You take anticoagulant or antiplatelet drugs.
• You have a history of high-dose X-ray treatment (radiation therapy) of the colon.
• You recently had a colon polyp removed.
WHAT ARE THE SIGNS OR SYMPTOMS?
Symptoms of this condition include:
• Bright red blood or blood clots coming from your rectum.
• Bloody stools.
• Black or maroon-colored stools.
• Pain or cramping in the abdomen.
• Weakness or dizziness.
• Racing heartbeat.
HOW IS THIS DIAGNOSED?
This condition may be diagnosed based on:
• Your symptoms and medical history.
• A physical exam. During the exam, your health care provider will check for signs of blood loss, such as low blood pressure and a rapid pulse.
• Tests, such as:
○ Flexible sigmoidoscopy. In this procedure, a flexible tube with a camera on the end is used to examine your anus and the first part of your colon to look for the source of bleeding.
○ Colonoscopy. This is similar to a flexible sigmoidoscopy, but the camera can extend all the way to the uppermost part of your colon.
○ Blood tests to measure your red blood cell count and to check for coagulopathy.
○ An imaging study of your colon to look for a bleeding site. In some cases, you may have X-rays taken after a dye or radioactive substance is injected into your bloodstream (angiogram).
HOW IS THIS TREATED?
Treatment for this condition depends on the cause of the bleeding. Heavy or persistent bleeding is treated at the hospital. Treatment may include:
• Getting fluids through an IV tube inserted into one of your veins.
• Getting blood through an IV tube (blood transfusion).
• Stopping bleeding through high-heat coagulation, injections of certain medicines, or applying surgical clips. This can all be done during a colonoscopy.
• Having a procedure that involves using a long, thin tube to inject a material in a blood vessel to block blood flow to the bleeding site (angiogram and embolization).
• Stopping some of your regular medicines for a certain amount of time.
• Having surgery to remove part of the colon. This may be needed if bleeding is severe and does not respond to other treatment.
FOLLOW THESE INSTRUCTIONS AT HOME:
• Take over-the-counter and prescription medicines only as told by your health care provider. You may need to avoid aspirin, NSAIDs, or other medicines that increase bleeding.
• Eat foods that are high in fiber. This will help keep your stools soft. These foods include whole grains, legumes, fruits, and vegetables. Eating 1–3 prunes each day works well for many people.
• Drink enough fluid to keep your urine clear or pale yellow.
• Keep all follow-up visits as told by your health care provider. This is important.
CONTACT A HEALTH CARE PROVIDER IF:
• Your symptoms do not improve.
GET HELP RIGHT AWAY IF:
• Your bleeding increases.
• You feel light-headed or you faint.
• You feel weak.
• You have severe cramps in your back or abdomen.
• You pass large blood clots in your stool.
• Your symptoms get worse.