Diverticular Bleeding


Diverticular Bleeding, Diverticular Hemorrhage

  • Epidemiology
  1. Most common cause of Lower Gastrointestinal Bleeding
  2. Severe, life threatening Lower Gastrointestinal Bleeding occur in 3% of patients with Diverticulosis
  • Risk Factors
  1. Age over 65 years
  2. Increased risk with NSAIDs or Aspirin
  • Pathophysiology
  1. Diverticula can occur anywhere in the Large Bowel
  2. Most common site for Diverticular Bleeding is at on ther right side, at the ascending colon (thinner wall)
  • Symptoms
  1. Painless Rectal Hemorrhage
  2. Irritate symptoms due to acute bleeding may occur
    1. Mild abdominal cramping
    2. Stool urgency
  • Signs
  1. Red to Maroon Stool which may contain intermixed blood clot
  • Course
  1. Bleeding spontaneously ceases in 75%, recurs in 38%
  2. Recurrence is 9% at one year and 25% at 4 years
  • Prevention
  1. Avoid Aspirin and NSAIDs
  2. Increase Dietary Fiber
  3. Weight loss in Obesity with goal Body Mass Index <30 kg/m2