Comprehensive Review of Lower Gastrointestinal Bleeding: Etiology, Diagnosis, and Management

Lower gastrointestinal bleeding (LGIB) is a complex and potentially life-threatening condition that presents significant diagnostic and therapeutic challenges across all age groups. This comprehensive review provides an in-depth analysis of LGIB, encompassing its epidemiology, pathophysiology, clinical presentation, and stateof-the-art management strategies. We systematically examine the diverse etiologies of LGIB, ranging from common benign conditions such as hemorrhoids and diverticulosis to more severe pathologies including colorectal cancer and angiodysplasia. Special attention is given to agespecific considerations, highlighting the distinct causes and management approaches in pediatric, adult, and elderly populations.The review critically evaluates current diagnostic modalities, emphasizing the pivotal role of colonoscopy as both a diagnostic and therapeutic tool, while also discussing the utility of advanced imaging techniques such as computed tomography angiography (CTA) and tagged red blood cell scintigraphy. We provide a detailed comparison of endoscopic, radiologic, and surgical interventions, supported by the latest evidence-based guidelines. Additionally, emerging technologies, including artificial intelligence in endoscopy and novel hemostatic techniques, are explored as potential future directions in LGIB management. Risk stratification models and pharmacotherapeutic options are thoroughly reviewed to guide clinicians in optimizing patient outcomes. The article concludes with practical algorithms for the management of acute and recurrent LGIB, ensuring a structured approach to patient care. This review serves as an authoritative resource for gastroenterologists, surgeons, and emergency physicians, offering a balanced synthesis of current knowledge and clinical best practices in the management of LGIB.