Lower gastrointestinal bleeding risk factors

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

Overview

Common risk factors in the development of lower GI bleeding include advancing age, previous history of gastrointestinal bleeding, chronic constipation, hematologic disorders, medications such as anticoagulants, non-steroidal anti-inflammatory drugs, and human immunodeficiency virus infection.

Common risk factors in the development of lower GI bleeding include:^[1]^[2]^[3]^[4]

Risk factor	Pathophysiology of bleeding
Chronic constipation	Results in colonic diverticula and predispose patients to anal fissures and hemorrhoid formation
Hematologic disorders	Deficiencies in clotting factors, such as factor VII and factor VIII, predispose to LGIB
Anticoagulants	Patients taking warfarin, heparin, aspirin, and platelet inhibitors are at increased risk of bleeding in general
Nonsteroidal anti-inflammatory drugs	NSAIDs cause ulceration in the terminal ileum and proximal colon, and can exacerbate IBD
Human immunodeficiency virus	In patients with HIV, bleeding is caused by opportunistic infections, cytomegalovirus colitis, Kaposi sarcoma, or lymphoma

↑ Navuluri R, Kang L, Patel J, Van Ha T (2012). “Acute lower gastrointestinal bleeding”. Semin Intervent Radiol. 29 (3): 178–86. doi:10.1055/s-0032-1326926. PMC 3577586. PMID 23997409.
↑ Strate LL (2005). “Lower GI bleeding: epidemiology and diagnosis”. Gastroenterol. Clin. North Am. 34 (4): 643–64. doi:10.1016/j.gtc.2005.08.007. PMID 16303575.
↑ Ríos A, Montoya MJ, Rodríguez JM, Serrano A, Molina J, Ramírez P, Parrilla P (2007). “Severe acute lower gastrointestinal bleeding: risk factors for morbidity and mortality”. Langenbecks Arch Surg. 392 (2): 165–71. doi:10.1007/s00423-006-0117-6. PMID 17131153.
↑ Strate LL, Orav EJ, Syngal S (2003). “Early predictors of severity in acute lower intestinal tract bleeding”. Arch. Intern. Med. 163 (7): 838–43. doi:10.1001/archinte.163.7.838. PMID 12695275.