Chapter 76: Lower Gastrointestinal Bleeding

Question 1

Most common cause of LGIB

Answer 1

Diverticular disease

Followed by Colitis, hemorrhoids, and adenomatous polyps/malignancies

Question 2

LGIB

Predictive of severe bleeding

Answer 2

nontender abdomen

Question 3

LGIB

Predictive of diverticular hemorrhage

Answer 3

aspirin or NSAID use

Factors associated with a high morbidity rate are hemodynamic instability
- repeated hematochezia
- gross blood on initial rectal examination
- initial hematocrit <35%
- syncope
- nontender abdomen** (predictive of severe bleeding)**
- history of diverticulosis or angioectasia
- elevated creatinine
- aspirin or NSAID use (predictive of diverticular hemorrhage)
- and more than two comorbid conditions

Question 4

TRUE OR FALSE

Consider placement of NGT if lower GI bleeding is significant

Answer 4

TRUE

Hematochezia unexpectedly originates from upper GI sources approximately