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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2019; 10(03): 158-162
DOI: 10.1055/s-0039-3401454
Original Article
Society of Gastrointestinal Endoscopy of India

Clinical Spectrum of Chronic Lower Gastrointestinal Bleeding in Sub-Himalayas: A Study at a Tertiary Care Hospital of North India

Vikas Lakhanpal
1   Department of Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
,
Rajesh Sharma
2   Department of Gastroenterology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
,
Vishal Bodh
2   Department of Gastroenterology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
,
Surinder Thakur
1   Department of Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
,
Neetu Sharma
3   Department of Physiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
,
Brij Sharma
2   Department of Gastroenterology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
› Author Affiliations
Further Information

Publication History

Publication Date:
12 December 2019 (online)

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Abstract

Background Lower gastrointestinal bleeding (LGIB) is fairly a common presentation in gastroenterology and medicine departments, and presents major diagnostic and therapeutic challenges. This study aimed to explore the varied clinical spectrum of LGIB in our region.

Methods A total of 138 patients presented with chronic LGIB and were investigated using colonoscopy and relevant investigations.

Results The majority of patients were in the age group of 40 to 59 years, with a mean age of 49.5 years, slight male predominance, and male-to-female ratio of 1.19:1. The most common clinical presentation was hematochezia (97.8%). Overall, 15% patients had more than one comorbidity, and 39.13% patients were anemic, of which 7.24% received blood transfusions. Diagnostic yield of colonoscopy was 92.75%.

Major causes of LGIB were anorectal causes (19.56%), inflammatory bowel disease (19.56%), colorectal carcinoma (17.39%), radiation proctitis (9.42%), infective causes (11.59%), nonspecific colitis (7.24%), and benign growths (5.07%). However, in the elderly (age > 60 years), carcinoma colon, radiation proctitis, and hemorrhoids predominated the clinical picture.

Conclusion Colonoscopy is very useful in the evaluation of patients with LGIB. The predominant causes of LGIB vary according to age as well as geographical location, and mortality of LGIB is negligible as compared with upper gastrointestinal bleeding.

Keywords

lower gastrointestinal bleeding - inflammatory bowel disease - solitary rectal ulcer syndrome - colonoscopy
 

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