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CC BY 4.0 · Journal of Digestive Endoscopy 2025; 16(02): 059-067
DOI: 10.1055/s-0045-1809364
Original Article

Lower Gastrointestinal Bleeding: Etiology and Outcomes at a Tertiary Care Center in South India—Are These Different from the West?

Noble Varghese Mathews 
1   Department of Medical Gastroenterology, Christian Medical College Vellore - Ranipet Campus, Tamil Nadu, India
,
Ebby George Simon 
1   Department of Medical Gastroenterology, Christian Medical College Vellore - Ranipet Campus, Tamil Nadu, India
,
Anoop John
1   Department of Medical Gastroenterology, Christian Medical College Vellore - Ranipet Campus, Tamil Nadu, India
,
L Jeyaseelan
2   Clinical Epidemiology Unit, Christian Medical College Vellore - Town Campus, Tamil Nadu, India
,
A. J. Joseph
1   Department of Medical Gastroenterology, Christian Medical College Vellore - Ranipet Campus, Tamil Nadu, India
,
Amit Kumar Dutta 
1   Department of Medical Gastroenterology, Christian Medical College Vellore - Ranipet Campus, Tamil Nadu, India
,
Reuben Thomas Kurien
1   Department of Medical Gastroenterology, Christian Medical College Vellore - Ranipet Campus, Tamil Nadu, India
,
Rajeeb Jaleel
1   Department of Medical Gastroenterology, Christian Medical College Vellore - Ranipet Campus, Tamil Nadu, India
,
Sudipta Dhar Chowdhury 
1   Department of Medical Gastroenterology, Christian Medical College Vellore - Ranipet Campus, Tamil Nadu, India
› Institutsangaben
Funding None.
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Abstract

Background and Objectives

Lower gastrointestinal bleeding (LGIB) is a common clinical condition with limited prospective data from South Asia. This study aimed to describe the clinical characteristics, diagnostic evaluation, therapeutic interventions, and outcomes of patients with LGIB at a tertiary care center in South India.

Materials and Methods

This prospective observational study included 150 patients with LGIB from August 2023 to July 2024. Patient demographics, clinical presentation, diagnostic procedures, interventions, and outcomes were recorded. Patients were followed up until 28 days post-discharge.

Results

The mean age of the patients was 50 years, with a male predominance (72%). Colitis (26%) was the most common etiology, followed by benign anorectal disorders (19%). Diagnostic yield for LGI endoscopy was 61%. Endoscopic therapy was performed in 5% of patients, radiological intervention in 3%, and surgery in 7%. Rebleeding rate was 7.9%, and readmission rate was 6.6%. Overall mortality was 5.3%, with higher rates among inpatient LGIB compared with those admitted with LGIB (19.2% versus 2.4%, p = 0.004). Seven of the eight deaths were secondary to underlying comorbid illnesses.

Conclusion

The etiological spectrum of LGIB in this South Indian center differs from Western studies, with colitis being the predominant cause. Most patients were managed conservatively. Mortality rates were similar to Western studies and primarily attributed to underlying comorbidities. Further multicenter studies are needed to develop appropriate management guidelines for the South Asian region.

Keywords

colonoscopy - etiology - lower gastrointestinal bleeding - outcomes - rebleeding

Authors' Contributions

N.V.M.: Study design, data collection, patient follow-up, formal analysis, original draft preparation, and final approval of the manuscript.

E.G.S.: Conceptualization, study design, methodology, formal analysis, data curation, review and editing, and final approval of the manuscript.

A.J.: Study design, data collection, patient follow-up, formal analysis, review and editing, and final approval of the manuscript.

L.J.: Study design, methodology, formal analysis, review and editing, and final approval of the manuscript.

A.J.J.: Study design, methodology, review and editing, and final approval of the manuscript.

A.M.K.: Study design, methodology, review and editing, and final approval of the manuscript.

R.T.K.: Methodology, review and editing, and final approval of the manuscript.

R.J.: Study design, review and editing, and final approval of the manuscript.

S.D.C.: Study design, review and editing, and final approval of the manuscript.


Ethical Approval

The study was approved by the Institutional Review Board (IRB Minute No.: 12013) (OBSERVE) dated April 24, 2019 and Institutional Ethics Committee.


Patients' Consent

All patients included in the study provided informed written consent to publish the study data.


Supplementary Material



Publikationsverlauf

Artikel online veröffentlicht:
27. Mai 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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