To Determine the Frequency of the Common Causes of Lower Gastrointestinal Bleeding after Colonoscopy

Abstract

Introduction: Lower Gastrointestinal Bleeding (LGIB) is defined as bleeding from distal to the ligament of Treitz at the duodeno-jejunal flexure and it accounts for 30-40% of all gastrointestinal bleeding. Although it is less common than the upper gastrointestinal bleeding yet considered as medical and surgical emergency particularly when massive. The leading causes of LGIB are hemorrhoids, rectal ulcers, rectal polyps and colitis; while less frequent causes include ulcerative colitis, Crohn's disease and diverticulitis.   This is apparently in contrast to the western literature where inflammatory bowel diseases and diverticulitis are the common cause of LGIB. Presently Colonoscopy is the diagnostic and therapeutic procedure of choice in LGIB.

Objective: To determine the frequency of the common causes of lower gastrointestinal bleeding (LGIB) after Colonoscopic examination in a tertiary care hospital of Lahore.

Methodology: This cross-sectional descriptive study was conducted at Department of Gastroenterology, Services institute of Medical Sciences Lahore (SIMS) from April 2016 to March 2017.

Results: A total of 277 patients were included in this study, 181(65.34%) were males and 96(34.65%) were females. The average age oi the patients was 45.5 years. Colonoscopy showed abnormal findings in 219 (79.06%) patients. The internal hemorrhoids were the most common cause of LGIB while least common cause of LGIB after Colonoscopic examination was malignant lesions of colon and rectum.

Conclusion: In our study bleeding from internal hemorrhoids was the leading cause of lower gastrointestinal bleeding followed by rectal ulcers and polyps.

Keywords: Lower GI Bleeding, Hemorrhoids, Rectal Ulcer, Rectal polyps, Colonoscopy.