Low-GI bleeding is all recent blood loss caused by a digestive tract injury that is distal to the Treitz ligament. This anatomical finding distinguishes HDB from the other type of digestive hemorrhage, upper digestive hemorrhage (HDA), the one whose origin would be above the ligament. Thus HDB includes any haemorrhage originating in the large intestine, including the rectum and anal canal, but also those originating in jejunum and ileum, both sections constituting the greater part of the small intestine. Its characteristic clinical presentation is the appearance of blood or blood traces through the anus in the form of hematochezia or rectal bleeding, although it may also occur in the form of melena or bloody feces. The amount of hemorrhage can be from minimal, without hemodynamic repercussion, to one of greater amount and severity. Other terms that are synonymous with HDB, such as low gastrointestinal bleeding (the literal translation of the term used in the Anglo-Saxon medical field), rectal bleeding, colonic bleeding, and hemorrhagic diarrhea are used.
HDB is not a disease but a clinical sign that manifests different diseases. The causes of HDB can be grouped into several categories: anatomical, such as diverticulosis; vascular, such as angiodysplasia, ischemia or radiation-induced; inflammatory disease, such as inflammatory bowel disease or intestinal infection; neoplastic, such as polyps or colon tumors; and iatrogenic, such as treatment with anticoagulant drugs. HDB is usually less severe than upper gastrointestinal bleeding. But although most HDB episodes are self-limiting and self-limiting, and many causes of HDB are relatively benign or do not pose a serious health hazard, the presence of such bleeding should be evaluated by a physician and in some cases I may need urgent evaluation and treatment.
HDB is less common than upper gastrointestinal bleeding. It accounts for between 20% and 30% of all episodes of gastrointestinal bleeding in general, with an annual incidence in Western countries of 20-27 cases per 100,000 inhabitants. However, it is considered that it is possibly underestimated since there are patients who do not see the doctor.The incidence is higher in males than in females. The prevalence of diverticulosis and vascular causes, which are common causes of HDB, are more frequent in the elderly. The overall mortality of HDB does not increase with age, especially after 60 years. is negligible (about 4% in one of the larger studies in this regard), especially in the older population group or with comorbidity, where mortality is even higher.
Due to its incidence and presentation, it is a reason for frequent consultation in the emergency department. Progress in diagnosis and treatment, mainly with the development of colonoscopy, but also with angiography and radiology intervention, have reduced the need for surgical treatment of this disease. The more effective management of HDB with less invasive treatments has allowed to reduce not only the hospitalization time of patients and the health costs that are derived but also, and much more importantly, the complications, morbidity and mortality of these patients patients.
History Knowledge about HDB, its diagnosis and treatment has changed drastically over the past 50 years. In the first half of the twentieth century the HBD of some gravity was, in many cases, a fatal outcome. It was considered that the different types of neoplastic lesions of colon - polyps and tumors - were the
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