Lower gastrointestinal bleeding in the elderly

Table 1 Causes of LGIB in the elderly

Diverticulosis coli

Vascular ectasia (telangiectasia)

Inflammatory disease of the colon

Neoplasms

Post-polypectomy bleeding

Hemorrhoids

Stercoral ulcer

Solitary ulcer syndrome

Dieulafoy’s lesion

Colo-rectal varices

LGIB: Lower gastrointestinal bleeding.

Table 2 Factors affecting the severity of LGIB in the elderly

Co-morbid diseases

Cardiovascular disease

Cerebrovascular disease

Diabetes mellitus

Renal disease

Cirrhosis

Hypertension

Neoplasia

Polypharmacy

Anticoagulants

NSAIDS

NSAIDS: Non-steroidal anti-inflammatory drugs.

Table 3 Endoscopic and radiologic modalities for the investigation of LGIB

Colonoscopy

Radionuclide scan

Abdominal angiography

Wireless capsule endoscopy

Push enteroscopy

Double balloon enteroscopy

Table 4 Modalities for the treatment of LGIB

Colonoscopy

Thermal coagulation, band ligation, metallic clips, epinephrine injection, sclerosing agent injection, fibrous glue

Abdominal angiography

Vasopressin infusion, embolization

Surgery