Spectrum of lower gastrointestinal hemorrhage: an endoscopic study of 166 patients.

BACKGROUND

The spectrum of lesions causing lower gastrointestinal hemorrhage shows marked geographic variation. The study was aimed to determine this spectrum in our region using endoscopic examination.

METHODS

166 patients presenting with lower gastrointestinal hemorrhage were investigated using colonoscopy as the first investigation.

RESULTS

Lesions responsible for bleeding could be identified in 141 patients (84.9%). In 25 patients (15.1%), the etiology of bleed could not be determined either because of failure to identify a lesion (10 patients) or because of an incomplete examination (15 patients). Major causes of lower gastrointestinal bleeding included idiopathic ulcerative colitis (19.3%), acute colitis (12.0%), colonic polyps (10.2%), radiation colitis (9.0%), solitary rectal ulcer (7.8%), colonic carcinoma (7.2%), colonic tuberculosis (4.2%) and enteric fever (3.0%).

CONCLUSION

Endoscopic examination is very useful in evaluating patients with lower gastrointestinal hemorrhage. The predominant causes of lower gastrointestinal bleeding in our experience are different from those reported from western countries.