Does Early Colonoscopy Improve Outcomes in Acute Lower GI Bleeding?

A large randomized trial shows no outcome differences between early versus elective colonoscopy.

For acute lower gastrointestinal bleeding (LGIB), current clinical guidelines recommend performing colonoscopy within 24 hours in high-risk patients after adequate colon purge and resuscitation to potentially improve the diagnostic and therapeutic yield. However, these recommendations are based on only a few single-center, low-quality studies.

In a multicenter, prospective trial conducted at 15 hospitals in Japan, 170 patients with acute LGIB were randomized to early colonoscopy (within 24 hours of presentation) or elective colonoscopy (24–96 hours after presentation). The mean time to colonoscopy was 14 hours in the early group and 41 hours in the elective group. The identification of stigmata of recent hemorrhage (SRH), the primary study o…

Reviewing Author

John R. Saltzman, MD

Disclosures

Consultant/Advisory BoardIterative Scopes

Editorial BoardsGastrointestinal Endoscopy; UpToDate

Leadership Positions in Professional SocietiesAmerican College of Gastroenterology (Trustee)

OtherVice President of Medical Affairs, 1Globe Health Institute