Lower gastrointestinal bleeding classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Lower gastrointestinal bleeding can be classified into occult, moderate and severe bleeding based on the severity of bleeding.

Lower GI bleeding can be classified into 3 groups based on the severity of bleeding:^[1]^[2]^[3]^[4]^[5]^[6]

	Severe lower GI bleeding	Moderate lower GI bleeding	Occult lower GI bleeding
Age	> 65 years	Occur at any age	Any age
Presenting symptoms	Hematochezia or bright red blood per rectum.	Hematochezia or melena	Symptoms of anemia (fatigue, tiredness)
Hemodynamics	Unstable	Stable	Stable
Lab findings	Hemoglobin equal to or less than 6 g/dl.	Microcytic anemia	Microcytic hypochromic anemia due to chronic blood loss.
Differential	Diverticulosis Angiodysplasia	Neoplastic disease Inflammatory Infectious Benign anorectal Congenital diseases	Inflammatory Neoplastic Congenital

↑ Lee EW, Laberge JM (2004). “Differential diagnosis of gastrointestinal bleeding”. Tech Vasc Interv Radiol. 7 (3): 112–22. PMID 16015555.
↑ Raju GS, Gerson L, Das A, Lewis B (2007). “American Gastroenterological Association (AGA) Institute medical position statement on obscure gastrointestinal bleeding”. Gastroenterology. 133 (5): 1694–6. doi:10.1053/j.gastro.2007.06.008. PMID 17983811.
↑ Rockey DC (2010). “Occult and obscure gastrointestinal bleeding: causes and clinical management”. Nat Rev Gastroenterol Hepatol. 7 (5): 265–79. doi:10.1038/nrgastro.2010.42. PMID 20351759.
↑ Rockey DC (2005). “Gastrointestinal bleeding”. Gastroenterol. Clin. North Am. 34 (4): 581–8. doi:10.1016/j.gtc.2005.08.002. PMID 16303571.
↑ Green BT, Rockey DC (2003). “Acute gastrointestinal bleeding”. Semin. Gastrointest. Dis. 14 (2): 44–65. PMID 12889580.
↑ Rockey DC (1999). “Occult gastrointestinal bleeding”. N. Engl. J. Med. 341 (1): 38–46. doi:10.1056/NEJM199907013410107. PMID 10387941.