Management of Acute Lower Gastrointestinal Bleeding

Target Audience: Gastroenterologists and emergency physicians primarily, and general surgeons and primary care providers secondarily

Background and Objective

In a new ACG clinical guideline on management of acute overt lower gastrointestinal (GI) bleeding, researchers developed evidence-based recommendations based on a systematic literature review. They defined lower GI bleeding as colorectal bleeding and not small-bowel bleeding, which has historically been included in the definition.

Key Recommendations

• Perform upper endoscopy for hematochezia with hemodynamic instability.

• Use a nasogastric tube to assess upper GI bleeding if suspicion is moderate; it can be left in place for c…