Lower GI hemorrhage

Abdominal aortic aneurysm Acute coronary syndrome (NSTEMI)Acute coronary syndrome (STEMI)Acute decompensated heart failure Acute limb ischemia Acute mesenteric ischemia Aortic dissection Aortic stenosis Atrial fibrillation and flutter Bradyarrhythmia and heart block Cardiac arrest Deep vein thrombosis Myocarditis Pericarditis Pulmonary embolism Stable angina Superficial thrombophlebitis Superior vena cava syndrome Supraventricular tachycardia Syncope (cardiogenic)Unstable angina Ventricular tachycardia

Acute bronchitis Acute respiratory failure Aspiration pneumonia Asthma exacerbation Bronchiolitis Community-acquired pneumonia COVID-19 pneumonia COPD exacerbation Croup Croup (laryngotracheobronchitis)Epiglottitis Hemothorax Hospital-acquired pneumonia Pleural effusion Pneumothorax (traumatic)Pulmonary contusion Spontaneous pneumothorax

Bell's palsy Benign paroxysmal positional vertigo Brain abscess Cauda equina syndrome Cervical radiculopathy Concussion (mild traumatic brain injury)Encephalitis Guillain-Barré syndrome Hemorrhagic stroke (intracerebral)Ischemic stroke Lumbar radiculopathy Malignant spinal cord compression Migraine Peripheral neuropathy (acute)Retropharyngeal abscess Schizophrenia (acute exacerbation)Seizure (breakthrough:known epilepsy)Seizure (first-time)Spinal cord injury Status epilepticus Subarachnoid hemorrhage Tension headache Transient ischemic attack Traumatic brain injury (moderate-severe)Vestibular neuritis Viral meningitis

Acute appendicitis Acute cholecystitis Acute diverticulitis Acute pancreatitis Anal fissure Choledocholithiasis and cholangitis Clostridioides difficile colitis Gastritis Gastroenteritis (viral and bacterial)Gastroesophageal reflux disease Incarcerated or strangulated hernia Inflammatory bowel disease flare Large bowel obstruction Lower GI hemorrhage Peptic ulcer disease Perforated viscus Small bowel obstruction Upper GI hemorrhage

Acute prostatitis Acute urinary retention Ectopic pregnancy Epididymitis Orchitis Ovarian torsion Paraphimosis Pelvic inflammatory disease Priapism Pyelonephritis Renal laceration Ruptured ovarian cyst Testicular torsion Tubo-ovarian abscess Urinary tract infection (uncomplicated)Urolithiasis (renal colic)Vaginal bleeding (non-pregnant)

Acute sinusitis Acute tonsillitis Acute upper respiratory infection Animal bite Bacterial meningitis Cellulitis Conjunctivitis (bacterial)Dental abscess Endocarditis Febrile neutropenia Fournier gangrene Hand-foot-mouth disease Hepatitis (acute)Herpes zoster HIV-related illness Human bite Impetigo Infected diabetic foot ulcer Infectious mononucleosis Influenza Necrotizing fasciitis Osteomyelitis Otitis externa Parasitic infection Periorbital cellulitis Peritonsillar abscess Scabies Sepsis Septic arthritis Spontaneous bacterial peritonitis Tick-borne illness (Lyme disease)Tinea infection Tuberculosis Viral exanthem Wound infection

Achilles tendon rupture ACL and mceniscus tear Ankle fracture Ankle sprain Burn Calcaneus fracture Cervical spine fracture Clavicle fracture Dental avulsion Distal radius fracture Drowning Elbow fracture and dislocation Electrical injury Facial bone fracture Facial laceration Femur fracture Fingertip amputation Forearm fracture (radius and ulna)Frostbite Hand:finger laceration Heat exhaustion Heat stroke Hip fracture Humeral shaft fracture Knee dislocation Knee sprain Lightning injury Mandible fracture Metacarpal fracture Metatarsal fracture Muscle strain Nasal fracture Non-accidental trauma Orbital fracture Patella fracture Phalanx fracture (finger)Proximal humerus fracture Pulmonary contusion Rib fracture Rotator cuff tear (acute traumatic)Scalp laceration Scaphoid fracture Shoulder dislocation Skull fracture Splenic laceration Sternal fracture Supracondylar pediatric fracture Tendon laceration (hand:wrist)Thoracic and lumbar spine fracture Tibia:fibula fracture Tibial plateau fracture Toe fracture Traumatic epistaxis Traumatic hyphema

Acetaminophen toxicity Alcohol intoxication Alcohol withdrawal Anticholinergic toxicity Anticoagulant overdose Benzodiazepine overdose Benzodiazepine:sedative overdose Beta-blocker and calcium channel blocker toxicity Carbon monoxide poisoning Caustic ingestion Digoxin toxicity Drug eruption Foreign body ingestion Opioid intoxication Opioid overdose Opioid withdrawal Organophosphate Salicylate toxicity Serotonin syndrome Stimulant intoxication (cocaine, methamphetamine)Tricyclic antidepressant overdose

Acute anxiety Acute psychosis Agitation:behavioral emergency Bipolar disorder Conversion disorder Major depressive episode Neuroleptic malignant syndrome Suicidal ideation and attempt

Acute low back pain (mechanical)Bursitis Cervical radiculopathy Costochondritis Gout (acute)Lumbar radiculopathy Pseudogout Tendinitis

Acute eczema (Eczema acute flare)Allergic contact dermatitis Erythema multiforme Henoch-Schönlein purpura Pressure injury Psoriasis (acute flare)Stevens-Johnson syndrome Toxic epidermal necrolysis Urticaria (acute)

Envenomation (snake, spider, insect)High-altitude illness Hypothermia

Acute chest syndrome Coagulopathy Hyperviscosity syndrome Sickle cell crisis (vaso-occlusive)Symptomatic anemia Thrombocytopenia (severe)Tumor lysis syndrome

Bronchiolitis Croup Emergency delivery Febrile seizure Kawasaki disease Neonatal jaundice Neonatal sepsis Nursemaid's elbow Pediatric fever 0 to 28 days Pediatric fever 29 to 60 days Pediatric fever 61 to 90 days Pyloric stenosis Slipped capital femoral epiphysis Intussusception

Adrenal crisis Diabetic ketoacidosis Hypercalcemia Hyperosmolar hyperglycemic state Hypertensive emergency Hypertensive urgency Hypoglycemia Myasthenia gravis crisis Myxedema coma Severe hyperkalemia Severe hyponatremia Thyroid storm

Acute laryngitis Acute otitis media Acute pharyngitis Cerumen impaction Epistaxis (anterior)Nasal foreign body Otitis externa Tympanic membrane perforation

Acute angle-closure glaucoma Central retinal artery occlusion Chemical eye injury Corneal abrasion Corneal ulcer Globe rupture Ocular foreign body Orbital cellulitis Retinal detachment

Hyperemesis gravidarum Painful vaginal bleeding in pregnancy Placenta previa Placental abruption Preeclampsia:eclampsia Preterm labor Threatened:inevitable:incomplete abortion

Anaphylaxis Angioedema Cannabis-induced hyperemesis

Lower GI hemorrhage

Clinical Assessment Checklist

Browse categories and answer follow-up questions to refine your symptom profile.

Triage and immediate priorities

Initial stabilization

Hemodynamic instability triggers

SBP <90 mmHg

MAP <65 mmHg

HR >120 beats/min

Shock index >1.0

Altered mental status

Ongoing brisk hematochezia

Resuscitation setting

Resuscitation bay for instability

Early senior support

Vascular access

Two large-bore peripheral IVs

If poor access, intraosseous access

If severe shock, central venous access

Monitoring

Continuous ECG

Continuous pulse oximetry

Noninvasive BP cycling q2-5 min

If ongoing shock, arterial line

Airway and ventilation

If inability to protect airway, RSI

If massive ongoing bleeding with aspiration risk, early intubation

Circulatory targets

MAP target 65 mmHg

Urine output target 0.5 mL/kg/hour

Mental status normalization target

Early hemorrhage control strategy

Bleeding localization priorities

If unstable or active brisk hematochezia, CT angiography first-line

If stable with continued bleeding, colonoscopy after prep

If recurrent or ongoing bleeding with positive CTA, interventional radiology

Consultation triggers

GI for suspected lower GI source requiring endoscopy

Interventional radiology for positive CTA or ongoing brisk bleeding

Surgery for refractory bleeding or ischemia or perforation concern

Transfusion and massive hemorrhage pathway

Blood product strategy

Packed red blood cells

Restrictive threshold Hb <70 g/L in most patients

Higher threshold Hb <80 g/L if active ischemic heart disease or persistent shock

Massive transfusion protocol

If ongoing hemodynamic instability with suspected massive bleeding, activate MTP

Balanced ratio strategy per local protocol

Platelets

Target >50 x10^9/L in active bleeding

Target >100 x10^9/L if planned high-risk endoscopic therapy

Fibrinogen replacement

If fibrinogen <1.5 g/L, cryoprecipitate or fibrinogen concentrate per protocol

Calcium repletion

If massive transfusion, calcium chloride IV bolus per protocol

Ionized calcium target within normal range

Antithrombotic and anticoagulant management

Anticoagulant and antiplatelet triage

Medication reconciliation

Warfarin

Apixaban

Rivaroxaban

Edoxaban

Dabigatran

Heparin infusion

Low molecular weight heparin

Aspirin

Clopidogrel

Ticagrelor

Prasugrel

Reversal decision points

Life-threatening bleeding definition

Hemodynamic instability

Ongoing bleeding requiring transfusion

Hb drop >20 g/L with ongoing bleeding

Need for emergent procedure

If life-threatening bleeding, reversal based on agent and timing

If non-life-threatening bleeding, individualized hold strategy

Key concepts

Lower GI hemorrhage framework

Definition

Bleeding distal to ligament of Treitz

Hematochezia common

Melena possible with right-sided colonic bleeding

High-risk patterns

Painless large-volume hematochezia suggests diverticular bleeding

Recurrent maroon stools suggests proximal colonic or small bowel source

Pain with bleeding suggests ischemic or inflammatory colitis

Medical Disclaimer

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.

Last Reviewed: January 15, 2026 by SymptomDX Medical Team

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.

← Management Protocols

Home Management ProtocolsLower GI hemorrhage

Lower GI hemorrhage

Clinical Assessment Checklist

Browse categories and answer follow-up questions to refine your symptom profile.

Triage and immediate priorities

Initial stabilization

Hemodynamic instability triggers

SBP <90 mmHg

MAP <65 mmHg

HR >120 beats/min

Shock index >1.0

Altered mental status

Ongoing brisk hematochezia

Resuscitation setting

Resuscitation bay for instability

Early senior support

Vascular access

Two large-bore peripheral IVs

If poor access, intraosseous access

If severe shock, central venous access

Monitoring

Continuous ECG

Continuous pulse oximetry

Noninvasive BP cycling q2-5 min

If ongoing shock, arterial line

Airway and ventilation

If inability to protect airway, RSI

If massive ongoing bleeding with aspiration risk, early intubation

Circulatory targets

MAP target 65 mmHg

Urine output target 0.5 mL/kg/hour

Mental status normalization target

Early hemorrhage control strategy

Bleeding localization priorities

If unstable or active brisk hematochezia, CT angiography first-line

If stable with continued bleeding, colonoscopy after prep

If recurrent or ongoing bleeding with positive CTA, interventional radiology

Consultation triggers

GI for suspected lower GI source requiring endoscopy

Interventional radiology for positive CTA or ongoing brisk bleeding

Surgery for refractory bleeding or ischemia or perforation concern

Transfusion and massive hemorrhage pathway

Blood product strategy

Packed red blood cells

Restrictive threshold Hb <70 g/L in most patients

Higher threshold Hb <80 g/L if active ischemic heart disease or persistent shock

Massive transfusion protocol

If ongoing hemodynamic instability with suspected massive bleeding, activate MTP

Balanced ratio strategy per local protocol

Platelets

Target >50 x10^9/L in active bleeding

Target >100 x10^9/L if planned high-risk endoscopic therapy

Fibrinogen replacement

If fibrinogen <1.5 g/L, cryoprecipitate or fibrinogen concentrate per protocol

Calcium repletion

If massive transfusion, calcium chloride IV bolus per protocol

Ionized calcium target within normal range

Antithrombotic and anticoagulant management

Anticoagulant and antiplatelet triage

Medication reconciliation

Warfarin

Apixaban

Rivaroxaban

Edoxaban

Dabigatran

Heparin infusion

Low molecular weight heparin

Aspirin

Clopidogrel

Ticagrelor

Prasugrel

Reversal decision points

Life-threatening bleeding definition

Hemodynamic instability

Ongoing bleeding requiring transfusion

Hb drop >20 g/L with ongoing bleeding

Need for emergent procedure

If life-threatening bleeding, reversal based on agent and timing

If non-life-threatening bleeding, individualized hold strategy

Key concepts

Lower GI hemorrhage framework

Definition

Bleeding distal to ligament of Treitz

Hematochezia common

Melena possible with right-sided colonic bleeding

High-risk patterns

Painless large-volume hematochezia suggests diverticular bleeding

Recurrent maroon stools suggests proximal colonic or small bowel source

Pain with bleeding suggests ischemic or inflammatory colitis

Medical Disclaimer

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.

Last Reviewed: January 15, 2026 by SymptomDX Medical Team

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.

← Management Protocols

Home Management ProtocolsLower GI hemorrhage