What are the nonsurgical options for lower gastrointestinal (GI) bleeding (LGIB)?

Updated: Jul 26, 2019
  • Author: Burt Cagir, MD, FACS; Chief Editor: BS Anand, MD  more...
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Answer

Hemostasis

Once the bleeding site is localized, nonsurgical therapeutic options that may be considered include the following:

  • Diverticular bleeding: Colonoscopy with bipolar probe coagulation, epinephrine injection, or metallic clips

  • Recurrent bleeding: Resection of the affected bowel segment

  • Angiodysplasia: Thermal therapy (eg, electrocoagulation, argon plasma coagulation)

  • Conservative management, including nothing by mouth (NPO) and IV hydration in patients with ischemic colitis

In patients in whom the bleeding site cannot be determined, vasoconstrictive agents such as vasopressin (Pitressin) can be used. If vasopressin is unsuccessful or contraindicated, superselective embolization is useful.


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