Unmasking the Hidden Culprits: Investigating the Diverse Causes of Lower Gastrointestinal Bleeding in a Younger Cohort

Abstract

Objective: To determine the frequency of different causes of Lower GI bleeding on colonoscopy in younger aged patients. Study type, settings & duration: This prospective, cross-sectional study was conducted at Endoscopy Unit, National Institute of Liver and Gastrointestinal Diseases, Dow University of Health Sciences, Karachi from September 2020 to September 2021. Methodology: In this study, patients presenting with lower GI bleed who underwent colonoscopy at inpatient, outpatient department and referral cases were asked to participate after obtained informed consent from them. The sampling technique used was consecutive sampling. Results: This study included 197 patients, 106 (53.8%) of whom had hemorrhoids alone, 59 (29.9%) had simultaneous diagnosis of hemorrhoids with other etiology, and 32 (16.2%) had aetiologies besides hemorrhoids. Hemorrhoids caused the most lower gastrointestinal bleeding (53.8%), followed by nonspecific ilietis/colitis (17.8%) and polyps (9.1%). Hemorrhoids affected older people and males more. Hemorrhoids were also more common among married and addict patients as compared to unmarried and non-addicted patients. Haemorrhoids was associated with increased weight loss (39.4% vs. 21.2%, p-value = 0.010) as well as antibiotic usage (35.1% vs. 32.4%, p-value = 0.006). Conclusion: The study reveals a significant association between age, gender, marital status, addiction history, weight loss, and antibiotic usage in the diagnosis and treatment of lower gastrointestinal bleeding.

Keywords

• Colonoscopy
• hemorrhoids
• gastrointestinal hemorrhages
• hematochezia