Etiology, Diagnosis And Treatment Of Lower Gastrointestinal Bleeding

OBJECTIVE:This study was aimed to investigate the etiology of lower gastrointestinal bleeding and the distribution characteristics between age and sex, to analyze the diagnosis and treatment of different diseases, and to discuss the exam of different etiological factors of LGIB.METHODS:Collect the patients with LGIB hospitalized in the Shandong Provincial Hospital with definite causes from 2011.1.1 to 2016.3.1 to process statistical analysis of their clinical data. According to the age, the patients were divided into older age-group, middle-aged group and young-group, and analyze whether the differences among them exists or not by comparing these three groups. Moreover, the patients were also divided into different sex group——male group and female group according to the sex. And also analyze whether the differences among them exists or not by comparing these two group. And discuss the way to diagnose and treat different disease of LGIB, and compare the positive rate between different exams of detecting OGIB.RESULTS:1. The major causes of LGIB were inflammatory of lower gastrointestinal tract (35.6%), colorectal polyps (20.9%), colorectal cancer (17.2%), vasculopathy of lower gastrointestinal tract (9.8%), hemorrhoids (7.0%), diverticulum (6.1%), OGIB (4.1%), intestinal tumors (4.1%), others (0.4%).2. The ratio of the older age-group to the all LGIH patients is the highest, followed by the middle-aged group, and the least was the young group. Statistical difference exists between different ages of LGIB patients (P<0.05). The most common disease of LGIB in the young-aged group and middle-aged group was inflammatory of lower gastrointestinal tract (56.4%,30.0%),, and the old-aged group was colorectal cancer (28.8%).3. Male patients(52.02%) were more than female patients (47.98%). However,the difference, was not statistically significant(P>0.05).4. When to diagnose the causes of LGIB, the clinical exams is different in different diseases and different organs. Colorectal diseases need colonoscopy, sometimes CT is also needed. However, the bowel bleeding is more difficult. First we should exclude UGIB and colorectal bleeding through gastroscopy and colonoscopy. Then depending the characteristics of different patients, we can use CE an, enteroscopy, enterograghy, CT, DSA, radionuclide imaging, intraoperative enteroscopy and surgery.Conclusions:1. The main etiological factors of LGIB were inflammatory of lower gastrointestinal tract, colorectal polyps, colorectal cancer, vasculopathy of lower gastrointestinal tract, hemorrhoids, diverticulum, OGIB, intestinal tumors, anaphylactoid purpura.2. The LGIB is related to age factors. The main etiological factor in the young-aged group was inflammatory of lower gastrointestinal tract. The main etiological factor of the middle-aged group was colorectal polyps, and the main etiological factor of the old-aged group was colorectal cancer. There is no difference between sex.3. Different diseases, different organs need different exams, colonoscopy is needed in most diseases.