Abstract
Background Lower gastrointestinal bleeding (LGIB) is fairly a common presentation in gastroenterology
and medicine departments, and presents major diagnostic and therapeutic challenges.
This study aimed to explore the varied clinical spectrum of LGIB in our region.
Methods A total of 138 patients presented with chronic LGIB and were investigated using colonoscopy
and relevant investigations.
Results The majority of patients were in the age group of 40 to 59 years, with a mean age
of 49.5 years, slight male predominance, and male-to-female ratio of 1.19:1. The most
common clinical presentation was hematochezia (97.8%). Overall, 15% patients had more
than one comorbidity, and 39.13% patients were anemic, of which 7.24% received blood
transfusions. Diagnostic yield of colonoscopy was 92.75%.
Major causes of LGIB were anorectal causes (19.56%), inflammatory bowel disease (19.56%),
colorectal carcinoma (17.39%), radiation proctitis (9.42%), infective causes (11.59%),
nonspecific colitis (7.24%), and benign growths (5.07%). However, in the elderly (age
> 60 years), carcinoma colon, radiation proctitis, and hemorrhoids predominated the
clinical picture.
Conclusion Colonoscopy is very useful in the evaluation of patients with LGIB. The predominant
causes of LGIB vary according to age as well as geographical location, and mortality
of LGIB is negligible as compared with upper gastrointestinal bleeding.
Keywords
lower gastrointestinal bleeding - inflammatory bowel disease - solitary rectal ulcer
syndrome - colonoscopy
