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Acute Lower Gastrointestinal Bleed: Review of Clinical Course and Outcome in Hospitalized Patients



Objective: This study reviewed the clinical features, aetiology and outcomes of patients with acute lower gastrointestinal bleed (ALGIB) admitted to the University Hospital of the West Indies, Jamaica, between January 2007 and December 2012.
Methods: Consecutive patients admitted with ALGIB were reviewed. Data collected comprised age, gender, prior episodes of ALGIB, co-morbid illness, vital signs, blood transfusion requirements, timing of colonoscopy and/or findings at surgery and outcomes.
Results: There were 189 patients reviewed with a mean age of 67 years. There was a predominance of females (55% vs 45%) with 80% of patients having at least one co-morbid illness. The use of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) was present in 24% and 16% of patients, respectively. A previous diagnosis of diverticular disease was found in 31%. Colonoscopy was performed in 72% of patients with a median time of four days to the procedure. Overall, 19% of patients required emergency surgery with no deaths. The leading causes of ALGIB were diverticular disease 56%, colorectal cancer and haemorrhoidal disease 11% each and colonic polyps 8.5%. Recurrent bleeding occurred in 3.7% and blood transfusion was given in 43%. The average hospitalization stay was seven days, eight days for patients 65 years or older. Overall mortality was 2.6%.
Conclusion: Acute lower gastrointestinal bleed occurred most frequently in the elderly population with the majority afflicted with co-morbid illnesses. Diverticular disease was the most common cause. Overall mortality (2.6%) was low and emergency surgery is associated with low mortality. Older patients had a longer hospital stay. 



11 Jul, 2016
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e-Published: 19 Jul, 2016
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