Suspected Lower GI Bleeding: When Do You Do an Upper Scope?

When bright, red blood appears in the lower gastrointestinal tract, is it coming from a colonic source, or from a massive upper GI bleed? The answer is critical to treatment and prognosis. Is urgent upper endoscopy called for in all cases, as suggested by some experts? What are gastroenterologists choosing to do in this situation, and why? Dr. M. Brian Fennerty discusses this challenge and poses a case study to solicit discussion of current practices. Read Gut Check and contribute to the discussion.