Lower gastro-intestinal bleeding

Adresse

Switzerland

Christian Toso
Professor
Christian Toso
Head of Division

Lower gastro-intestinal bleeding refers to digestive bleeding occurring after the duodenum  and the beginning of the small intestine ( Treitz's angle ), which usually manifests as bloody stool.

The main causes of lower gastro-intestinal bleeding are vascular malformations (angiodysplasias), diverticular disease (diverticulosis), colitis, proctological pathologies (hemorrhoids, anal fissures, rectal ulcers),  intestinal polyps or colorectal cancer.

Initial assessment includes medical examination, blood tests and hemodynamic stabilization which may include blood transfusion. If the bleeding is important and active, the initial evaluation consists of gastroscopy (in order to exclude a higher gastro-intestinal bleeding which can manifest itself as bloody stool - hematochezia in 10-15% of cases), then, possibly an abdominal CT scan. If the bleeding is less important, and/or as a second step, a colonoscopy is performed. Additional tests may be required if the cause of the bleeding cannot be found.

Surgical treatment as a last resort

Treatment depends on the cause of the lower gastro-intestinal bleeding. It consists of stopping the bleeding by endoscopic hemostasis (endoscopy ) in the majority of cases. Surgery is only very rarely necessary, in situations where other measures have failed.

Duodenum
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The beginning of the intestine
Colonoscopy
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Visual exploration of the gastro-intestinal tract, carried out using a probe fitted with a camera inserted into the rectum, used to highlight lesions of the inner lining of the colon
Endoscopy
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Method to visualize the internal organs and cavities for diagnostic or therapeutic purposes, carried out using an endoscope, a tube to which the end is attached to a lamp and a camera
INFO +  Echo-endoscopy (FR)
Last update : 04/01/2022