Lower gastrointestinal bleeding history and symptoms

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

The hallmark symptom of lower gastrointestinal bleeding (LGIB) is bleeding per rectum or frank blood in stools. The presentation of associated symptoms depends upon the source of the bleeding and underlying etiology. Associated symptoms of lower gastrointestinal bleeding include fever, abdominal pain, bloody diarrhea, dehydration, history of constipation, hypotension in severe cases, and weight loss. A detailed description of the nature of the blood loss can also help in finding the likely source of bleeding.

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

• 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 inquired.

• A history of recent colonic polypectomy or biopsy indicates iatrogenic bleeding.

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

• The most common presentation of LGIB is bleeding per rectum or frank blood in stools.^[1][2][3]
• The associated symptoms of LGIB varies with the underlying pathology and source of the bleeding.
• Commonly, LGIB from the right side of the colon can manifest as maroon stools, whereas a left-sided bleeding source may be evidenced by bright red blood per rectum.
• The following table summarizes the various associated symptoms of LGIB depending on the etiology.

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