LOWER GASTROINTESTINAL TRACT BLEEDING

LOWER GASTROINTESTINAL TRACT BLEEDING

When the source of bleeding is below the duodenojejunal fexure it is called lower gastrointestinal tract bleeding.The bleeding may be fresh, altered or occult. It can be devided into 3 groups

1. Patients with minor bleeding (OCCULT ):-It is that which is detected by routine chemical tests of the stool. About 10 ml blood loss per day is necessary to have stool occult blood test positive

2.Patients with slow bleeding (MODERATE) This patient may become anaemic

3.Patients with rapid bleeding (SEVERE) This patient may re:-quire blood transfusion

CAUSES:-

Causes may be divided into two main groups- local causes and general causes.

LOCAL CAUSES:-

Haemorrhoids

anal fissure

ulceration

fistula in ano

cancer

ruptured perianal haematoma(thrombosed pile)

ruptured anorectal abscess

injury

various types of polyps

GENERAL CAUSES:-

Liver failure

renal failure

blood dyscrasias

some drugs

DIAGNOSIS:-

Abdominal and rectal examination by a qualified doctor is mandatory, which may require

rectal and digital examination

proctoscopy

sigmoidoscopy

colonoscopy

TREATMENT:-

This will depend upon the cause of bleeding. Local management of cause and general management of patient is required to stabilise the patient.