Occult and Lower Gastronintestinal Bleed - Differential Diagnosis Algorithm



Occult (Stool + Occult blood and/or iron deficiency anemia)

 • Colorectal cancer

 • Angiodysplasia (colon or small bowel)

 • Occult UGI bleeding (ulcer, esophagitis, gastritis, cancer)

 • Other: small bowel tumors, asymptomatic IBD



Overt Bleeding

In Patient

 • RULE OUT BRISK Upper GI bleed, Diverticular bleed,

 • Acute colitis (ischemia, infectious, inflammatory),

 • Small bowel source (e.g. Meckel's, tumor),

 • Angiodysplasia

Out Patient

 • Perianal Disease (most common)

 • Inflammatory Bowel Disease

 • Colorectal Cancer



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