Evaluation of patients hospitalized with lower gastrointestinal system bleeding over a five-year period in a university hospital

Öztürk, H. Evaluation of Patients Hospitalized with Lower Gastrointestinal System Bleeding Over a Five-Year Period in a University Hospital. Eskişehir Osmangazi University Faculty of Medicine, Department of Internal Medicine, Medical Specialty Thesis, Eskişehir, 2025. Lower gastrointestinal (GI) bleeding has long remained a common and significant clinical problem, particularly affecting the elderly population. Our study was a single-center, retrospective analysis including 271 patients, aiming to contribute to the literature by comparing our findings with existing data. Lower GI bleeding was more frequently observed in older patients, with a mean age of 68.4 years. The proportion of male patients (59.8%) was higher than that of females. Hematochezia was the most common presenting symptom (60.9%). Cardiovascular diseases were the most frequent comorbidities, present in 67.9% of cases. The most common etiologies identified via colonoscopy were hemorrhoids (34.3%), polyps (33.9%), and diverticula (22.1%). The mean hospital stay was 5.66 ± 3.93 days. Supportive care and conservative treatment were the main therapeutic approaches, while invasive procedures such as surgery (4.1%) and embolization (0.4%) were less frequently performed. Patients with a prior history of lower GI bleeding presented with more severe anemia and required more erythrocyte transfusions. The presence of syncope or hemorrhagic shock at admission, as well as a previous history of GI bleeding, was associated with lower hemoglobin levels and increased transfusion needs. Patients with diverticula were significantly older, while those with inflammatory bowel disease (IBD) were significantly younger than others. In conclusion, advanced age, comorbid conditions, and clinical presentation significantly affect prognosis in lower GI bleeding cases. Therefore, diagnostic and therapeutic processes should be carried out with greater caution and a multidisciplinary approach.