Lower Gastrointestinal Bleeding: Etiology and Outcomes at a Tertiary Care Center in South India—Are These Different from the West?

Abstract Lower gastrointestinal bleeding (LGIB) is a common clinical condition with limited prospective data from South Asia. This study aimed to describe the clinical characteristics, diagnostic evaluation, therapeutic interventions, and outcomes of patients with LGIB at a tertiary care center in South India. This prospective observational study included 150 patients with LGIB from August 2023 to July 2024. Patient demographics, clinical presentation, diagnostic procedures, interventions, and outcomes were recorded. Patients were followed up until 28 days post-discharge. The mean age of the patients was 50 years, with a male predominance (72%). Colitis (26%) was the most common etiology, followed by benign anorectal disorders (19%). Diagnostic yield for LGI endoscopy was 61%. Endoscopic therapy was performed in 5% of patients, radiological intervention in 3%, and surgery in 7%. Rebleeding rate was 7.9%, and readmission rate was 6.6%. Overall mortality was 5.3%, with higher rates among inpatient LGIB compared with those admitted with LGIB (19.2% versus 2.4%, p = 0.004). Seven of the eight deaths were secondary to underlying comorbid illnesses. The etiological spectrum of LGIB in this South Indian center differs from Western studies, with colitis being the predominant cause. Most patients were managed conservatively. Mortality rates were similar to Western studies and primarily attributed to underlying comorbidities. Further multicenter studies are needed to develop appropriate management guidelines for the South Asian region.