No Benefit of Early Colonoscopy for Acute Lower Gastrointestinal Bleeding

Elective colonoscopy performed after 24 hours and when first available should now be standard practice.

Current U.S. gastroenterology society guidelines recommend the performance of early colonoscopy (within 24 hours) in patients hospitalized for acute lower gastrointestinal bleeding (LGIB). However, a recent randomized trial showed no benefit of early colonoscopy in this setting (NEJM JW Gastroenterol Dec 2019 and Gastroenterology 2020; 158:168), and most prior studies of early colonoscopy in LGIB have been observational.

To further analyze the available evidence, investigators performed a systematic review and meta-analysis of the four published randomized, controlled trials of early versus later colonoscopy in acute LGIB, including two studies published in 2019. The meta-analysis showed no difference in risk for further bleeding with early …

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