Calc Function

  • Diagnosis
  • Rule Out
  • Prognosis
  • Formula
  • Treatment
  • Algorithm
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    Management of Patients With Acute Lower Gastrointestinal Bleeding

    Official guideline from the American College of Gastroenterology.

    summary by Shawn Shah, MD Carl Crawford, MD

    Initial Assessment

    Risk Stratification

    Strong recommendation
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    Very low quality evidence

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Low quality evidence

    Resuscitation

    Strong recommendation
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    Very low quality evidence

    Conditional recommendation
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    Low quality evidence

    Anticoagulant Management

    Conditional recommendation
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    Very low quality evidence

    Conditional recommendation
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    Very low quality evidence

    Conditional recommendation
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    Very low quality evidence

    Strong recommendation
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    Very low quality evidence

    Colonoscopy

    Diagnosis

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Very low quality evidence

    Timing

    Conditional recommendation
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    Low quality evidence

    Conditional recommendation
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    Low quality evidence

    Bowel Prep

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Low quality evidence

    Endoscopic Hemostasis

    Strong recommendation
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    Low quality evidence

    Conditional recommendation
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    Low quality evidence

    Conditional recommendation
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    Low quality evidence

    Strong recommendation
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    Very low quality evidence

    Strong recommendation
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    Very low quality evidence

    Recurrence and Non-scope Interventions

    Repeat Scope, Early Recurrence

    Strong recommendation
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    Very low quality evidence

    Non-scope Interventions

    Conditional recommendation
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    Very low quality evidence

    Strong recommendation
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    Very low quality evidence

    Conditional recommendation
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    Very low quality evidence

    Prevention of Recurrence

    Strong recommendation
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    Low quality evidence

    Strong recommendation
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    Low quality evidence

    Strong recommendation
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    Low quality evidence

    How strong is the ACG's recommendation?

    Strong recommendation
    Intervention's desirable effects clearly outweigh undesirable effects.
    Moderate recommendation
    Further research likely to impact confidence in estimate of effect.
    Conditional recommendation
    Uncertainty in tradeoffs between desirable & undesirable effects of intervention.
    Uncertainty in tradeoffs between desirable & undesirable effects of intervention.
    High quality evidence
    Further research unlikely to change guideline authors' confidence in estimate of effect.
    Between high and moderate levels of evidence.
    Moderate quality evidence
    Further research likely to impact confidence in estimate of effect.
    Low quality evidence
    Further research expected to have important impact in confidence in estimate of effect.
    Very low quality evidence
    Effect is very uncertain.