Lower gastrointestinal bleeding risk factors: Difference between revisions
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{{CMG}} ; {{AE}} {{ADG}} | {{CMG}} ; {{AE}} {{ADG}} | ||
==Overview== | ==Overview== | ||
Common risk factors in the development of lower GI bleeding include advancing age, previous history of gastrointestinal bleeding, chronic [[constipation]], [[Hematologic diseases|hematologic disorders]], medications such as [[Anticoagulants|anticoagulants]], [[non-steroidal anti-inflammatory drugs]], and [[HIV AIDS|human immunodeficiency virus infection]]. | |||
==Risk Factors== | ==Risk Factors== | ||
Common risk factors in the development of lower GI bleeding include:<ref name="pmid23997409">{{cite journal |vauthors=Navuluri R, Kang L, Patel J, Van Ha T |title=Acute lower gastrointestinal bleeding |journal=Semin Intervent Radiol |volume=29 |issue=3 |pages=178–86 |year=2012 |pmid=23997409 |pmc=3577586 |doi=10.1055/s-0032-1326926 |url=}}</ref><ref name="pmid16303575">{{cite journal |vauthors=Strate LL |title=Lower GI bleeding: epidemiology and diagnosis |journal=Gastroenterol. Clin. North Am. |volume=34 |issue=4 |pages=643–64 |year=2005 |pmid=16303575 |doi=10.1016/j.gtc.2005.08.007 |url=}}</ref><ref name="pmid17131153">{{cite journal |vauthors=Ríos A, Montoya MJ, Rodríguez JM, Serrano A, Molina J, Ramírez P, Parrilla P |title=Severe acute lower gastrointestinal bleeding: risk factors for morbidity and mortality |journal=Langenbecks Arch Surg |volume=392 |issue=2 |pages=165–71 |year=2007 |pmid=17131153 |doi=10.1007/s00423-006-0117-6 |url=}}</ref><ref name="pmid12695275">{{cite journal |vauthors=Strate LL, Orav EJ, Syngal S |title=Early predictors of severity in acute lower intestinal tract bleeding |journal=Arch. Intern. Med. |volume=163 |issue=7 |pages=838–43 |year=2003 |pmid=12695275 |doi=10.1001/archinte.163.7.838 |url=}}</ref> | Common risk factors in the development of lower GI bleeding include:<ref name="pmid23997409">{{cite journal |vauthors=Navuluri R, Kang L, Patel J, Van Ha T |title=Acute lower gastrointestinal bleeding |journal=Semin Intervent Radiol |volume=29 |issue=3 |pages=178–86 |year=2012 |pmid=23997409 |pmc=3577586 |doi=10.1055/s-0032-1326926 |url=}}</ref><ref name="pmid16303575">{{cite journal |vauthors=Strate LL |title=Lower GI bleeding: epidemiology and diagnosis |journal=Gastroenterol. Clin. North Am. |volume=34 |issue=4 |pages=643–64 |year=2005 |pmid=16303575 |doi=10.1016/j.gtc.2005.08.007 |url=}}</ref><ref name="pmid17131153">{{cite journal |vauthors=Ríos A, Montoya MJ, Rodríguez JM, Serrano A, Molina J, Ramírez P, Parrilla P |title=Severe acute lower gastrointestinal bleeding: risk factors for morbidity and mortality |journal=Langenbecks Arch Surg |volume=392 |issue=2 |pages=165–71 |year=2007 |pmid=17131153 |doi=10.1007/s00423-006-0117-6 |url=}}</ref><ref name="pmid12695275">{{cite journal |vauthors=Strate LL, Orav EJ, Syngal S |title=Early predictors of severity in acute lower intestinal tract bleeding |journal=Arch. Intern. Med. |volume=163 |issue=7 |pages=838–43 |year=2003 |pmid=12695275 |doi=10.1001/archinte.163.7.838 |url=}}</ref> | ||
* Advancing age | * Advancing age | ||
* Previous history of gastrointestinal bleed | * Previous history of gastrointestinal bleed | ||
* Chronic constipation | * Chronic [[constipation]] | ||
* Hematologic disorders | * [[Hematologic disease|Hematologic disorders]] | ||
* Anticoagulants | * [[Anticoagulant therapy|Anticoagulants]] | ||
* | * [[Non-steroidal anti-inflammatory drug|Non-steroidal anti-inflammatory drugs]] | ||
* Human immunodeficiency virus | * [[AIDS|Human immunodeficiency virus infection]] | ||
{| class="wikitable" | {| class="wikitable" | ||
|'''Risk factor''' | |'''Risk factor''' | ||
|'''Pathophysiology of bleeding''' | |'''Pathophysiology of bleeding''' | ||
|- | |- | ||
|Chronic constipation | |Chronic [[constipation]] | ||
|Results in colonic diverticula and predispose patients to anal fissures and hemorrhoid formation | |Results in colonic [[Diverticular|diverticula]] and predispose patients to [[anal fissures]] and [[hemorrhoid]] formation | ||
|- | |- | ||
|Hematologic disorders | |[[Hematologic]] disorders | ||
|Deficiencies in clotting factors, such as factor VII and factor VIII, predispose | |Deficiencies in [[clotting factors]], such as [[factor VII]] and [[factor VIII]], predispose to LGIB | ||
|- | |- | ||
|Anticoagulants | |[[Anticoagulants]] | ||
|Patients taking warfarin | |Patients taking [[warfarin]], [[heparin]], [[aspirin]], and [[platelet]] inhibitors are at increased risk of bleeding in general | ||
|- | |- | ||
|Nonsteroidal anti-inflammatory drugs | |[[Nonsteroidal anti-inflammatory drugs]] | ||
|NSAIDs cause ulceration in the terminal ileum and proximal colon, and can exacerbate IBD | |[[NSAIDs]] cause [[ulceration]] in the [[terminal ileum]] and proximal [[colon]], and can exacerbate [[Inflammatory bowel disease|IBD]] | ||
|- | |- | ||
|Human immunodeficiency virus | |[[Human Immunodeficiency Virus (HIV)|Human immunodeficiency virus]] | ||
|In patients with HIV, bleeding is caused by opportunistic infections, cytomegalovirus colitis, Kaposi sarcoma, or lymphoma | |In patients with [[Human Immunodeficiency Virus (HIV)|HIV]], bleeding is caused by [[opportunistic infections]], [[cytomegalovirus]] [[colitis]], [[Kaposi sarcoma]], or [[lymphoma]] | ||
|} | |} | ||
Latest revision as of 15:06, 26 December 2017
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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
Common risk factors in the development of lower GI bleeding include advancing age, previous history of gastrointestinal bleeding, chronic constipation, hematologic disorders, medications such as anticoagulants, non-steroidal anti-inflammatory drugs, and human immunodeficiency virus infection.
Risk Factors
Common risk factors in the development of lower GI bleeding include:[1][2][3][4]
- Advancing age
- Previous history of gastrointestinal bleed
- Chronic constipation
- Hematologic disorders
- Anticoagulants
- Non-steroidal anti-inflammatory drugs
- Human immunodeficiency virus infection
| Risk factor | Pathophysiology of bleeding |
| Chronic constipation | Results in colonic diverticula and predispose patients to anal fissures and hemorrhoid formation |
| Hematologic disorders | Deficiencies in clotting factors, such as factor VII and factor VIII, predispose to LGIB |
| Anticoagulants | Patients taking warfarin, heparin, aspirin, and platelet inhibitors are at increased risk of bleeding in general |
| Nonsteroidal anti-inflammatory drugs | NSAIDs cause ulceration in the terminal ileum and proximal colon, and can exacerbate IBD |
| Human immunodeficiency virus | In patients with HIV, bleeding is caused by opportunistic infections, cytomegalovirus colitis, Kaposi sarcoma, or lymphoma |
References
- ↑ 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.
- ↑ Strate LL (2005). "Lower GI bleeding: epidemiology and diagnosis". Gastroenterol. Clin. North Am. 34 (4): 643–64. doi:10.1016/j.gtc.2005.08.007. PMID 16303575.
- ↑ Ríos A, Montoya MJ, Rodríguez JM, Serrano A, Molina J, Ramírez P, Parrilla P (2007). "Severe acute lower gastrointestinal bleeding: risk factors for morbidity and mortality". Langenbecks Arch Surg. 392 (2): 165–71. doi:10.1007/s00423-006-0117-6. PMID 17131153.
- ↑ Strate LL, Orav EJ, Syngal S (2003). "Early predictors of severity in acute lower intestinal tract bleeding". Arch. Intern. Med. 163 (7): 838–43. doi:10.1001/archinte.163.7.838. PMID 12695275.