Lower GI Bleed
Seeing blood in the toilet, on the outside of your stool, or with wiping after a bowel movement is common. Fortunately, most of the causes of such rectal bleeding are not life-threatening; common causes include hemorrhoids and anal fissures - UpToDate
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HWN Suggests
Aspirin and Vitamin C Together at Last
Taking any dose of aspirin on a regular basis can triple your risk of dangerous gastrointestinal bleeding, according to some studies. The risk of this well-known aspirin side effect rises sharply when alcohol consumption is added.
Additional research indicates that if you're consuming just one serving of alcohol every day while taking aspirin on a regular basis, the risk of bleeding increases by another 250 percent. In other words, if you are one of the millions of Americans who have a glass of wine each day in the hope of improving your health, but are also taking aspirin, your risk of internal bleeding becomes seven times greater than if you didn't drink or take aspirin.
But…
Resources
Lower GI bleeding guidance. St Emlyn’s
If no bleeding sites is found on CT Angiography or colonoscopy and the patient has haemodynamic instability then consider that this may be an upper GI bleed with rapid transit of blood to the lower bowel.
LVAD Management in the GI Bleed Patient
Mike Misch presents a case of a patient with a left ventricular assist device (LVAD) with a postoperative acute lower GI bleed and answers practical questions...
Understanding Rectal Bleeding
Rectal bleeding often reveals itself as bright red blood on the toilet paper–usually after a bowel movement–or by turning the toilet bowl water red. Rectal bleeding can also present as extremely dark stool, ranging in color from deep red/maroon to black, and sometimes appearing tar-like (melena). The color of the blood can indicate where the bleeding is occurring: Bright red blood usually indicates bleeding low in the colon or rectum Dark red or maroon blood usually indicates bleeding higher in the colon or the small bowel Melena usually indicates bleeding in the stomach, such as bleeding from ulcers
Aspirin and Vitamin C Together at Last
Aspirin side effects kill about a thousand people a year in the US. If aspirin were a new drug, it would have a tough time getting approved by the FDA and would only be available by prescription.
Management of acute lower GI bleeding: British Society of Gastroenterology guidelines
These guidelines focus on the diagnosis and management of acute LGIB in adults, including methods of risk assessment and interventions to diagnose and treat bleeding (colonoscopy, computed tomography, mesenteric angiography, endoscopic therapy, embolisation and surgery). Recommendations are included on the management of patients who develop LGIB while receiving anticoagulants (including direct oral anticoagulants) or antiplatelet drugs. The appropriate use of blood transfusion is also discussed, including haemoglobin triggers and targets.
Diagnosis of gastrointestinal bleeding: A practical guide for clinicians
This review summarizes the overall diagnostic approach to gastrointestinal bleeding and provides a practical guide for clinicians.
FP Notebook
Extensive resource
Patient
The term rectal bleeding is often used by doctors to mean any blood that is passed out when you go to the toilet to pass faeces. However, not all bleeding that is passed out actually comes from the rectum. The blood can come from anywhere in the gut (the gastrointestinal tract). The more correct term is gastrointestinal tract bleeding, often abbreviated to GI bleeding.
Pediatrics Clerkship
Although gastrointestinal bleeding is worrisome for parents, unlike adult medicine, it is rarely associated with malignancies in pediatrics.
StatPearls
For lower GI bleeds, all-cause in-hospital mortality is low—less than 4%. Death from LGIB itself is rare, with most in-hospital mortality occurring from other comorbid conditions. Increased risk of death corresponded to increasing age (as seen in cases of UGIB as well), comorbid conditions, and intestinal ischemia.
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