Lower GI bleeding account for 20% of all acute GI bleeding.
That's a large percentage. The initial evaluation includes DRE,
stands for digital rectal examination, and with this bleeding taking place,
you need to make sure that the blood pressure is properly stabilized.
The nuclear scan may be useful for persistent bleeding of unclear source.
Nuclear scan. Colonoscopy may be used in active bleeding.
We'll talk about colonoscopy in the, when you would use it and when you would not,
but for the most part, you wanna make sure
that you will be able to find the source of this lower GI bleeding.
Angiographic embolization of the bleeding source,
most effective therapy in setting up an active bleed.
But literally, by blocking the bleeding, most effective in terms of halting the actual loss.
The causes and differentials that you wanna keep in mind: Diverticular disease;
painless rectal bleeding; diverticulosis, you have heard of.
We will talk about this in great detail. Angiodysplasia is right up there.
Do not forget about what made that, then happened with in blood vessels
in which there might be dysplasia. Inflammatory bowel disease especially ulcerative colitis.
More bleeding but remember, Crohn´s could also result in lower GI bleeding.
Ischemia is a big time important and an emergent matter that we'll talk about,
and known as your ischemic bowel disease.
Cancers, Meckel´s diverticulum, and hemorrhoids
may all be important differentials for lower GI bleeding.