Lower gastrointestinal bleeding natural history, complications and prognosis
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Lower gastrointestinal bleeding Microchapters |
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Differentiating Lower gastrointestinal bleeding from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
If left untreated, lower gastrointestinal bleeding is usually self-limited (90% of the time bleeding stops on its own). Massive blood loss can result in a severe drop in blood pressure resulting in decreased blood supply to organ systems leading to death. Hypovolemic shock and symptomatic anemia are the most common direct complications of LGIB. Prognosis is generally good, and the 1-year mortality rate of patients with lower gastrointestinal bleeding is less than 3%.
Natural History, Complications, and Prognosis
Natural History
If left untreated, lower gastrointestinal bleeding is usually self-limited (90% of the time bleeding stops on its own). Massive blood loss can result in a severe drop in blood pressure resulting in decreased blood supply to organ systems leading to death. Chronic blood loss if left untreated results in anemia.[1]
Complications
Common complications of LGIB include:[2][3]
- Hypovolemic shock and symptomatic anemia are the most common direct complications of LGIB.
- Rebleeding following treatment is not uncommon.
- All treatment modalities have potential adverse affects:
- Endoscopy carries a risk of bowel perforation.
- Angiography and superselective embolization can result in bowel ischemia.
- Surgery is associated with the highest complication rates and should only be considered in patients who have ongoing bleeding that cannot be controlled by other methods.
Prognosis
- Prognosis is generally good, and the 1 year mortality rate of patients with lower gastrointestinal bleeding is approximately <3%.[4][5]
- With definitive intervention to treat or remove the source of blood loss, rebleeding rates are low.
- Without definitive treatment, rebleeding rates can be appreciable, as high as 38%.
References
- ↑ Waggershauser CH, Storr M (2016). "[Lower gastrointestinal bleeding]". MMW Fortschr Med (in German). 158 (9): 50–1. doi:10.1007/s15006-016-8208-y. PMID 27155708.
- ↑ Navuluri R, Kang L, Patel J, Van Ha T (2012). "Acute lower gastrointestinal bleeding". Semin Intervent Radiol. 29 (3): 178–86. doi:10.1055/s-0032-1326926. PMC 3577586. PMID 23997409.
- ↑ Chait MM (2010). "Lower gastrointestinal bleeding in the elderly". World J Gastrointest Endosc. 2 (5): 147–54. doi:10.4253/wjge.v2.i5.147. PMC 2998909. PMID 21160742.
- ↑ Sanfilippo G, Patanè R, Fusto A, Passanisi G, Valenti R, Russo A (1986). "Endoscopic approach to childhood coeliac disease". Acta Gastroenterol. Belg. 49 (4): 401–8. PMID 3577609.
- ↑ "Lower gastrointestinal tract bleeding: a problem based approach - Surgical Treatment - NCBI Bookshelf".