Etiology, clinical presentation, diagnosis and management of lower gastrointestinal bleed in a Tertiary Care Hospital in India: A retro-prospective study
Introduction: Lower gastrointestinal bleeding (LGIB) is one of the leading causes for hospital admissions in gastroenterology wards all over the world. Patients usually present with hematochezia or bloody diarrhea. Colonoscopy is usually the initial diagnostic intervention followed by other more sop...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2015-07-01
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| Series: | Journal of Digestive Endoscopy |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/0976-5042.165697 |
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| author | Imtiyaz Ahmad Dar Waseem Raja Dar Mushtaq Ahmad Khan Basharat Ahmad Kasana Najeeb Ullah Sofi Moomin Hussain Faheem Arshad Manzoor Ahmad Wani Muzamil Latief Jaswinder Singh Sodhi |
| author_facet | Imtiyaz Ahmad Dar Waseem Raja Dar Mushtaq Ahmad Khan Basharat Ahmad Kasana Najeeb Ullah Sofi Moomin Hussain Faheem Arshad Manzoor Ahmad Wani Muzamil Latief Jaswinder Singh Sodhi |
| author_sort | Imtiyaz Ahmad Dar |
| collection | DOAJ |
| description | Introduction: Lower gastrointestinal bleeding (LGIB) is one of the leading causes for hospital admissions in gastroenterology wards all over the world. Patients usually present with hematochezia or bloody diarrhea. Colonoscopy is usually the initial diagnostic intervention followed by other more sophisticated tests. Bleeding may stop spontaneously, but evaluation is important because patients may harbor a sinister lesion like cancer. Aim of the Study: To determine the various etiologies, clinical presentations, a diagnostic test used and treatments received by LGIB patients admitted in our department. Materials and Methods: A total of 300 cases were studied which included 180 retrospective cases and 120 prospective cases. For retrospective cases, all the information was obtained by analyzing their case records while as prospective patients were managed as per a predefined protocol and details of various investigations and treatments documented. Results: Most commonly affected was elderly population (>60 years), constituting 40% (120/300) of studied population. Males constituted 59% (177/300) and females 41% (123/300). The most common clinical presentation of LGIB in our patients was hematochezia (63.6%, 191/300). Growth/polyp was the most common finding on colonoscopic examination seen in 29.3% (n = 88) patients. Inflammatory lesions were seen in 77 out of 239 (25.7%) patients. Wireless capsule endoscopy was positive in 13 out of 24 patients (54%). Computed tomography (CT) enterography showed positive results in 6 out of 25 (24%) cases. Red blood cell scan was done in seven patients while as CT angiography in in four patients. Therapeutic endoscopy was successful in 115 out of 239 patients with positive colonoscopy, polypectomy was the commonest procedure performed. Medical management was carried out in 34.6% patients. Surgical treatment was offered to 21% patients. Conclusion: Colonoscopy is the initial and most common investigation used in the evaluation of GI bleed. A polyp is the most common diagnosis while as polypectomy the most common therapeutic procedure. |
| first_indexed | 2024-12-19T06:02:09Z |
| format | Article |
| id | doaj.art-a55608041c934af1aa29eca1381397a4 |
| institution | Directory Open Access Journal |
| issn | 0976-5042 0976-5050 |
| language | English |
| last_indexed | 2024-12-19T06:02:09Z |
| publishDate | 2015-07-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Journal of Digestive Endoscopy |
| spelling | doaj.art-a55608041c934af1aa29eca1381397a42022-12-21T20:33:16ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Digestive Endoscopy0976-50420976-50502015-07-0160310110910.4103/0976-5042.165697Etiology, clinical presentation, diagnosis and management of lower gastrointestinal bleed in a Tertiary Care Hospital in India: A retro-prospective studyImtiyaz Ahmad Dar0Waseem Raja Dar1Mushtaq Ahmad Khan2Basharat Ahmad Kasana3Najeeb Ullah Sofi4Moomin Hussain5Faheem Arshad6Manzoor Ahmad Wani7Muzamil Latief8Jaswinder Singh Sodhi9Department of Medicine, Gastroenterology Division, Shere Kashmir Institute of Medical Sciences, Soura, Jammu and Kashmir, IndiaDepartment of Medicine, Gastroenterology Division, Shere Kashmir Institute of Medical Sciences, Soura, Jammu and Kashmir, IndiaDepartment of Medicine, Gastroenterology Division, Shere Kashmir Institute of Medical Sciences, Soura, Jammu and Kashmir, IndiaDepartment of Medicine, Gastroenterology Division, Shere Kashmir Institute of Medical Sciences, Soura, Jammu and Kashmir, IndiaDepartment of Medicine, Gastroenterology Division, Shere Kashmir Institute of Medical Sciences, Soura, Jammu and Kashmir, IndiaDepartment of Medicine, Gastroenterology Division, Shere Kashmir Institute of Medical Sciences, Soura, Jammu and Kashmir, IndiaDepartment of Medicine, Gastroenterology Division, Shere Kashmir Institute of Medical Sciences, Soura, Jammu and Kashmir, IndiaDepartment of Medicine, Gastroenterology Division, Shere Kashmir Institute of Medical Sciences, Soura, Jammu and Kashmir, IndiaDepartment of Medicine, Oncology Division, Shere Kashmir Institute of Medical Sciences, Soura, Jammu and KashmirDepartment of Medicine, Gastroenterology Division, Shere Kashmir Institute of Medical Sciences, Soura, Jammu and Kashmir, IndiaIntroduction: Lower gastrointestinal bleeding (LGIB) is one of the leading causes for hospital admissions in gastroenterology wards all over the world. Patients usually present with hematochezia or bloody diarrhea. Colonoscopy is usually the initial diagnostic intervention followed by other more sophisticated tests. Bleeding may stop spontaneously, but evaluation is important because patients may harbor a sinister lesion like cancer. Aim of the Study: To determine the various etiologies, clinical presentations, a diagnostic test used and treatments received by LGIB patients admitted in our department. Materials and Methods: A total of 300 cases were studied which included 180 retrospective cases and 120 prospective cases. For retrospective cases, all the information was obtained by analyzing their case records while as prospective patients were managed as per a predefined protocol and details of various investigations and treatments documented. Results: Most commonly affected was elderly population (>60 years), constituting 40% (120/300) of studied population. Males constituted 59% (177/300) and females 41% (123/300). The most common clinical presentation of LGIB in our patients was hematochezia (63.6%, 191/300). Growth/polyp was the most common finding on colonoscopic examination seen in 29.3% (n = 88) patients. Inflammatory lesions were seen in 77 out of 239 (25.7%) patients. Wireless capsule endoscopy was positive in 13 out of 24 patients (54%). Computed tomography (CT) enterography showed positive results in 6 out of 25 (24%) cases. Red blood cell scan was done in seven patients while as CT angiography in in four patients. Therapeutic endoscopy was successful in 115 out of 239 patients with positive colonoscopy, polypectomy was the commonest procedure performed. Medical management was carried out in 34.6% patients. Surgical treatment was offered to 21% patients. Conclusion: Colonoscopy is the initial and most common investigation used in the evaluation of GI bleed. A polyp is the most common diagnosis while as polypectomy the most common therapeutic procedure.http://www.thieme-connect.de/DOI/DOI?10.4103/0976-5042.165697capsule endoscopycolonoscopyhematochezialower gastrointestinal bleedred blood cell scanpolypectomy |
| spellingShingle | Imtiyaz Ahmad Dar Waseem Raja Dar Mushtaq Ahmad Khan Basharat Ahmad Kasana Najeeb Ullah Sofi Moomin Hussain Faheem Arshad Manzoor Ahmad Wani Muzamil Latief Jaswinder Singh Sodhi Etiology, clinical presentation, diagnosis and management of lower gastrointestinal bleed in a Tertiary Care Hospital in India: A retro-prospective study Journal of Digestive Endoscopy capsule endoscopy colonoscopy hematochezia lower gastrointestinal bleed red blood cell scan polypectomy |
| title | Etiology, clinical presentation, diagnosis and management of lower gastrointestinal bleed in a Tertiary Care Hospital in India: A retro-prospective study |
| title_full | Etiology, clinical presentation, diagnosis and management of lower gastrointestinal bleed in a Tertiary Care Hospital in India: A retro-prospective study |
| title_fullStr | Etiology, clinical presentation, diagnosis and management of lower gastrointestinal bleed in a Tertiary Care Hospital in India: A retro-prospective study |
| title_full_unstemmed | Etiology, clinical presentation, diagnosis and management of lower gastrointestinal bleed in a Tertiary Care Hospital in India: A retro-prospective study |
| title_short | Etiology, clinical presentation, diagnosis and management of lower gastrointestinal bleed in a Tertiary Care Hospital in India: A retro-prospective study |
| title_sort | etiology clinical presentation diagnosis and management of lower gastrointestinal bleed in a tertiary care hospital in india a retro prospective study |
| topic | capsule endoscopy colonoscopy hematochezia lower gastrointestinal bleed red blood cell scan polypectomy |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/0976-5042.165697 |
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