ACUTE LOWER GASTROINTESTINAL-BLEEDING - A GUIDE TO INITIAL MANAGEMENT

Initial assessment of any patient with acute gastrointestinal bleeding includes thorough history taking and physical examination, with speci al attention to orthostatic changes in vital signs as a guide to sever ity of blood loss. The next crucial step is exclusion of massive upper gastrointestinal hemorrhage. Once that is accomplished, a lower gastr ointestinal source should be sought, Diagnostic options include bleedi ng scans, colonoscopy, and angiography, The latter two measures confer therapeutic advantages, especially for diverticular disease and angio dysplastic lesions, which are the most common causes of acute lower ga strointestinal bleeding.