ABSTRACT
Lower gastrointestinal bleeding includes any source of bleeding distal to the ligament of Treitz. However, upper gastrointestinal bleeding may mimic a lower gastrointestinal bleed, presenting with similar symptoms and signs in up to 10% of patients. An acute presentation with haemodynamic instability and a requirement for blood and colloid infusion may require urgent investigation and intervention. Surgical intervention with partial or subtotal colectomy was also a common approach. Colonoscopy is the initial investigation of choice. In patients with gastrointestinal symptoms the investigations are appropriately targeted towards the pathological processes that explain both the blood loss and the symptoms. Bowel preparation for elective colonoscopy or barium enema may be performed using one of a number of available preparations. The alternative to inducing haemostasis by adrenaline injection is the use of various heat-producing devices. The constant flow of argon gas ensures that blood is blown away, which permits a better view of the treatment area.
