What is the treatment for massive 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

Massive LGIB is a life-threatening condition; although this condition manifests as maroon stools or bright red blood from the rectum, patients with massive upper GI bleeding (UGIB) may also present with similar findings. Regardless of the level of the bleeding, one of the most important elements in the management of patients with massive UGIB or LGIB is the initial resuscitation. These patients should receive two large-bore intravenous (IV) catheters and isotonic crystalloid infusions. Meanwhile, perform rapid assessment of vital signs, including heart rate, systolic blood pressure, pulse pressure, and urine output. Orthostatic hypotension (ie, a blood pressure fall of >10 mm Hg) is usually indicative of blood loss of more than 1000 mL.


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