II. Epidemiology

  1. Most common cause of Lower Gastrointestinal Bleeding
  2. Severe, life threatening Lower Gastrointestinal Bleeding occur in 3% of patients with Diverticulosis

III. Risk Factors

  1. Age over 65 years
  2. Increased risk with NSAIDs or Aspirin

IV. 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)

V. Symptoms

  1. Painless rectal Hemorrhage
  2. Irritate symptoms due to acute bleeding may occur
    1. Mild abdominal cramping
    2. Stool urgency

VI. Signs

  1. Red to maroon stool which may contain intermixed blood clot

VIII. Course

  1. Bleeding spontaneously ceases in 75%, recurs in 38%
  2. Recurrence is 9% at one year and 25% at 4 years

X. Prevention

  1. Avoid Aspirin and NSAIDs
  2. Increase Dietary Fiber
  3. Weight loss in Obesity with goal Body Mass Index <30 kg/m2

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