What medication is used for lower gastrointestinal (GI) bleeding?

From the Guidelines

Medications for Lower Gastrointestinal (GI) Bleeding For the management of lower gastrointestinal bleeding, medications such as tranexamic acid may be considered at a dose of 1-1.5 grams orally every 8 hours for 3-5 days to promote hemostasis 1. Additionally, proton pump inhibitors (PPIs) like pantoprazole or esomeprazole may be administered at a dose of 40-80 mg intravenously every 24 hours for 3-5 days to reduce gastric acid secretion, although their use is more commonly associated with upper GI bleeding 1.

• Key considerations for medication use in lower GI bleeding include:
  • The use of tranexamic acid to promote hemostasis in cases of bleeding due to angiodysplasia or diverticulosis 1
  • The administration of PPIs to reduce gastric acid secretion, particularly in patients at increased risk of GI bleeding 1
  • The potential interactions between PPIs and other medications, such as clopidogrel, and the need to carefully consider these interactions when selecting medications for patients with lower GI bleeding 1

From the Research

Medication for Lower Gastrointestinal (GI) Bleeding

There are several medications and treatments that can be used to manage lower gastrointestinal bleeding, including:

• Octreotide, a synthetic analogue of somatostatin, which can reduce splanchnic blood flow and has been used to treat variceal bleeding 2
• Vasopressin infusion, which can be used to treat LGIB, although it is not as commonly used as other treatments 3
• Embolization, which can be used to control bleeding in cases where endoscopy or other treatments are not effective 3, 4

Treatment Approaches

The choice of treatment for LGIB depends on the severity of the bleeding, the patient's hemodynamic status, and the availability of resources. Treatment approaches may include:

• Colonoscopy, which is the diagnostic and therapeutic procedure of choice for acute and chronic bleeding 5, 6, 4
• Angiography, which can be used to diagnose and treat bleeding, particularly in cases where colonoscopy is not possible or has failed 6, 3, 4
• Surgery, which may be necessary in severe cases of bleeding where other treatments have failed 6, 4