Clinical Profile and Colonoscopic Findings in Patients Presented with Lower Gastrointestinal Bleeding

Background: Lower gastrointestinal bleeding (LGIB) is a frequent cause of hospitalisation worldwide, but data from Bangladesh are limited. Colonoscopy provides both diagnostic and therapeutic benefit in this setting. Methods: We conducted a retrospective observational study of 100 consecutive patients with LGIB at Popular Diagnostic Centre, Medinova Medical Services and Labaid Diagnostic, Barishal, Bangladesh from January to December 2023, over one year. Demographic, clinical, laboratory, colonoscopic, and outcome data were collected. Statistical analysis included Chi-square/Fisher’s exact test, t-test/ANOVA, and exploratory logistic regression for predictors of significant pathology (carcinoma, polyps, colitis). Results: The mean age was 53.0 ± 13.5 years; 58% were male. Haematochezia (41%) was the most common presentation, and mean haemoglobin was 9.9 g/dL. Colonoscopy showed haemorrhoids in 39%, colorectal carcinoma in 23%, diverticulosis in 15%, colitis in 10%, polyps in 8%, and angiodysplasia in 5%. All angiodysplasia cases required intervention; endoscopic therapy was also frequent in haemorrhoids (62%) and carcinoma (74%). Overall, 80% of patients stabilised with medical or endoscopic therapy, 15% required surgery (mainly in diverticulosis, colitis, carcinoma), and mortality was 1%, confined to advanced carcinoma. Logistic regression did not identify significant predictors of pathology, though trends suggested lower odds among males and higher odds with increasing haemoglobin. Conclusion: In this Bangladeshi tertiary cohort, haemorrhoids were the leading cause of LGIB, with carcinoma forming a substantial minority. Most patients stabilised without surgery, and mortality was confined to one carcinoma case. These findings underscore the importance of colonoscopy for both diagnosis and treatment, and highlight the need for larger multicentre studies to refine risk stratification.