ASGE Recognized Industry Associate (ARIA) Training Program for Regeneron | June 2022-GI_Tract_in_Disease-Large_Intestine_Lower_GI_Bleeding

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This document provides an overview of several conditions related to the gastrointestinal tract. The large intestine is discussed in relation to colorectal cancer, lower gastrointestinal bleeding, and diverticulosis. Colorectal cancer is described as cancer located in the colon or rectum and one of the most common cancers in the US. The natural history of colorectal cancer is outlined, including the progression from hyper-proliferation to adenomatous polyps, high-grade dysplasia, and invasive cancer. The clinical presentation of colorectal cancer can range from asymptomatic to obstructive and emergent. Screening tests for colorectal cancer are also mentioned, such as guaiac-based fecal occult blood tests and colonoscopy.<br /><br />Lower gastrointestinal bleeding, which includes bleeding from the colon and small intestine, is discussed next. Symptoms of lower gastrointestinal bleeding include hematochezia, melena, anemia, lightheadedness, chest pain, shortness of breath, and syncope. Various causes of lower gastrointestinal bleeding are mentioned, including anatomic, vascular, inflammatory, and malignancy-related causes. Management of lower gastrointestinal bleeding involves volume resuscitation, exclusion of upper gastrointestinal bleeding, and interventions such as hemoclipping or colonoscopy with hemostasis.<br /><br />Diverticulosis is described as outpouchings of colonic mucosa and submucosa, which increase in incidence with age. Most cases of diverticulosis are asymptomatic and can be an incidental finding on diagnostic tests. Complications of diverticulosis include diverticulitis and diverticular bleeding. Diverticulitis is inflammation of a diverticulum and can be diagnosed through a CT scan. Treatment of diverticulitis depends on whether it is complicated or uncomplicated. Diverticular bleeding occurs when an artery erodes into the base of a diverticulum, resulting in painless rectal bleeding. Treatment options for diverticular bleeding include colonoscopy, angiography, and surgery.<br /><br />The document also briefly mentions hemorrhoids, which are swollen veins in the anal canal. Causes of hemorrhoids include prolonged sitting, chronic constipation, straining, pregnancy, and pelvic tumors. Diagnosis of hemorrhoids can be done through rectal examination, anoscopy, or colonoscopy. Treatment options for hemorrhoids range from conservative measures such as avoiding constipation and sitz baths, to procedures like rubber band ligation, sclerotherapy, or hemorrhoidectomy.

Asset Subtitle

Darrell Pardi, MD

Keywords

gastrointestinal tract

large intestine

colorectal cancer

lower gastrointestinal bleeding

diverticulosis

natural history

adenomatous polyps

clinical presentation

screening tests

hemorrhoids