Gastrointestinal Bleeding in elderly (MCQ)

                    Q. What is the most common cause of lower GI bleeding in elderly?

                    a. Haemorrhoids

                    b. Angiodysplasia

                    c. Colorectal Carcinoma

                    d. Polyps

            Answer: b. Angiodysplasia

If the options had included diverticulosis, it would have been the correct answer but since it’s not provided second-best answer will be angiodysplasia.

The causes of lower gastrointestinal bleeding may be grouped into several categories:

●Anatomic (diverticulosis)

●Vascular (angiodysplasia, ischemic, radiation-induced)

●Inflammatory (inflammatory bowel disease, infectious)

●Neoplastic

Diverticulosis is the most common source of lower GI bleeding. Angiodysplasia may be the most frequent cause in patients over the age of 65 years (i.e., elderly), though recent data suggest that angiodysplasia may be a less common cause of lower GI bleeding than once thought. Bleeding from angiodysplasia is venous in origin (in contrast to arterial bleeding with diverticula) and therefore tends to be less massive than diverticular bleeding

Haemorrhoids are the most common cause of rectal bleeding in patients under the age of 50 years.

The causes of acute hematochezia are as following (Descending order of occurrence overall):

●Diverticulosis

●Ischemia

●Anorectal (haemorrhoids, anal fissures, rectal ulcers)

●Neoplasia (polyps and cancers)

●Angiodysplasia

●Post polypectomy

●Inflammatory bowel disease

●Colitis (Radiation> infectious, antibiotic associated, ischemic, unknown cause)

●Small bowel/upper GI bleed

●Other causes.

Topic: Lower Gastrointestinal bleeding, Gastroenterology.

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