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Imaging & Endoscopy PR exam & proctoscopy Flexible sigmoidoscopy colitis, hemorrhoids, polyps Colonoscopy full bowel inspection CT Angiography for active, large volume bleeds Technetium scan Meckels diverticulum, angiodysplasia Small bowel enema, capsule endoscopy for obscure bleeds Emergency Management of Lower GI Bleeding Step 1: Resuscitation PR exam + rigid sigmoidoscopy IV fluids, crossmatch blood Monitor vitals, urine output Step 2: Identify Source Major PR bleed CT angiography + intervention Stable colonoscopy (prepped/unprepped) Step 3: Targeted Management Diverticular bleed often self-limiting Angiodysplasia endoscopic coagulation or angiographic embolization Polyps/cancer polypectomy or surgery Meckels diverticulum surgical resection Ischemia fluids, antibiotics, surgery if infarcted Hemorrhoids/fissure local measures, dietary fiber, topical agents Surgical Management Options Laparotomy for uncontrolled bleeding Resection for tumors, ischemia On-table colonoscopy in acute setting Split colostomy if life-threatening & unstable FAQs About Lower GI Bleeding Is bright red blood in stool always serious

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