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This practice guidance updates the 2016 ACG guideline on lower gastrointestinal bleeding (LGIB; NEJM JW Gastroenterol Aug 2016 and Am J Gastroenterol 2016; 111:459). It is a systematic review using the GRADE framework to categorize strength of recommendations and quality of supporting evidence. In addition, it includes recommendations based on expert opinion (termed “key concepts”). Here, we highlight a few important recommendations.
Risk stratification:
The previous guidelines recommended urgent (i.e., within 24 hours) colonoscopy in most patients who are hospitalized with LGIB. However, because evidence that urgent colonoscopy improves outcomes is lacking, this upd…