Lower gastrointestinal bleeding history and symptoms

Lower gastrointestinal bleeding Microchapters
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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]

History and Symptoms

History

• A detailed description of the nature of the blood loss can help in pinpointing the likely source of bleeding.

Past Medical History

• History of recurrent bleeds suggests bleeding from angiodysplasia.
• Associated weight loss suggests malignancy.
• Presence of systemic diseases such as atherosclerotic disease, IBD, coagulopathies, and HIV, and a history of pelvic irradiation for malignancy should be enquired.

Past Surgical History

• A history of recent colonic polypectomy or biopsy indicates iatrogenic bleeding.
  • This is usually low grade and limited, although it can be severe if an underlying artery is involved or if there is an inadequate coagulation of the polypectomy stalk.
  • In 1.5% of polypectomies bleeding occurs immediately. However, delayed bleeding can occur several hours or days following the procedure.

Family history

• A family history of diseases such as IBD or colorectal malignancy should be considered.