ACG LGIB 2023 — Management of Patients With Acute Lower Gastrointestinal Bleeding

Use risk tools such as the Oakland score to support disposition; a score <=8 can help identify very-low-risk patients who may be suitable for outpatient management when otherwise appropriate, whereas higher scores do not by themselves mandate ICU admission. In ongoing hemodynamically significant hematochezia, CTA is an important early localization test that can guide transcatheter embolization. Consider an upper GI source and urgent EGD when the clinical presentation supports it rather than requiring nasogastric aspiration/EGD before all lower-GI investigations. Most inpatient colonoscopy can be performed nonurgently after adequate preparation once the patient is stabilized.