Addressing acute gastrointestinal emergencies: From hemorrhage to obstruction

Sultan Mohammed Alanazi; Hatim Faihan Alotaibi; Ibrahim Mohammed Alanazi; Adel Mohammad Aldukhain; Salman Abdullah Alharbi; Hamoud Ghayyadh Alanizi; Fayez Abdullah Hussain Alsari; Rayan Salem Abdulaziz Alghufaili; Sulaiman Ahmed Almansour

doi:10.53730/ijhs.v3nS1.15137

Authors

Sultan Mohammed Alanazi KSA, National Guard Health Affairs
Hatim Faihan Alotaibi KSA, National Guard Health Affairs
Ibrahim Mohammed Alanazi KSA, National Guard Health Affairs
Adel Mohammad Aldukhain KSA, National Guard Health Affairs
Salman Abdullah Alharbi KSA, National Guard Health Affairs
Hamoud Ghayyadh Alanizi KSA, National Guard Health Affairs
Fayez Abdullah Hussain Alsari KSA, National Guard Health Affairs
Rayan Salem Abdulaziz Alghufaili KSA, National Guard Health Affairs
Sulaiman Ahmed Almansour KSA, National Guard Health Affairs

Keywords:

Gastrointestinal bleeding, lower gastrointestinal bleeding, colonoscopy, predictive models, risk stratification, early intervention

Abstract

Background: Gastrointestinal bleeding (GIB) has traditionally been divided into upper and lower gastrointestinal bleeding (UGIB and LGIB). Advances in diagnostic technologies, including capsule endoscopy and balloon-assisted enteroscopy, have refined our understanding of small bowel bleeding, leading to a revised classification system encompassing upper, mid, and lower GIB. The rising incidence of LGIB is attributed to an aging population and increased antithrombotic use. Despite improvements in UGIB management, effective preventive strategies for LGIB remain insufficient, with significant hospitalization and mortality rates. Aim: This review aims to consolidate current knowledge on the initial management of acute LGIB, addressing advancements in predictive scoring systems, risk stratification, and the role of early colonoscopy. Methods: A comprehensive literature review was conducted, focusing on recent advancements and guidelines, including the 2016 American College of Gastroenterology guidelines for acute LGIB and the American Society for Gastrointestinal Endoscopy guidelines on antithrombotic management. Results: The review highlights the challenges in managing acute LGIB, including the diverse etiology of bleeding, the need for effective risk stratification tools, and the optimization of colonoscopy timing. New predictive models, such as the NOBLADS score and other risk scoring systems, provide valuable insights into severe LGIB outcomes.

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