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Letter
Management of acute lower GI bleeding: evidence-based medicine?
  1. John S Leeds1,
  2. Anthoor Jayaprakash2,
  3. David S Sanders3
  1. 1Department of Gastroenterology, Freeman Hospital, Newcastle upon Tyne, UK
  2. 2Gastroenterology, Northumbria Healthcare NHS F Trust, Ashington, UK
  3. 3Gastroenterology and Liver Unit, Royal Hallamshire Hospital, Sheffield, UK
  1. Correspondence to Dr John S Leeds, Department of Gastroenterology, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK; j.leeds{at}nhs.net

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We read with interest the guidelines concerning the management of acute lower GI bleeding (LGIB) by Oakland et al including the assessment algorithm and congratulate the authors for their work in what is an evidence light area.1 LGIB is a common presenting condition; however, previous data show that in the majority of cases, bleeding stops without the need for any intervention.2 In the national audit, only 3.1% of 2528 cases received any direct intervention to help control LGIB of which 2.1% was endoscopic, 0.8% embolisation and 0.2% surgery and overall mortality was low (3.4%).3 It is well recognised in upper GI bleeding that the role of endoscopy is for delivering a therapeutic intervention to reduce the risk of rebleeding and need for surgery. There is …

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