Endoscopic Findings in Patients Presented With Lower GIT Bleeding in Assiut University Hospitals, a Single-centre Study

NCT07073300 | Not Yet Recruiting DMC FDA Device

• 1 other identifier: Endoscopic findings in LGIB
• Study Type: observational
• Target: 110
• Locations: 0 countries
• Sites: N/A

Brief Summary

Lower gastrointestinal bleeding (LGIB) refers to hematochezia or bright blood passing per rectum of colorectal source distal to ileocecal valve. This differs from the old definition of LGIB which involved small intestine distal to the ligament of Treitz. The new definition of LGIB aligns with current clinical practice and the reality that the majority of LGIB cases come from colorectal origin . In north America, LGIB is one fifth to one third as common as upper gastrointestinal bleeding (UGIB) and represents 30-40 % of all gastrointestinal bleeding cases . 20.5 - 27 cases per 100,000 adults are diagnosed to have LGIB with 21 to 40 cases per 100,000 adults are hospitalized . LGIB has a wide range of aetiologies, presentation and severity. The clinical picture of LGIB depends on patient's age, aetiology and associated comorbidities . Patients can present with overt bleeding in the form of hematochezia which is defined as passage of bright blood per rectum. This should be differentiated from melena (the passage of dark, offensive and digested blood with stool) associated with UGIB . However, 10-15 % of patients with severe acute UGIB can present with hematochezia . In addition, Occult LGIB can present in the form of iron deficiency anaemia or faecal occult bleeding . Causes of LGIB vary significantly according to patient age, lifestyle, dietary habits and geography or race. Some of the most common causes of LGIB include haemorrhoids, colorectal polyps, malignancy, colitis (infective, inflammatory, ischemic, etc.) as well as diverticular disease . However, there are limited data about the common causes of LGIB in upper Egypt.

Conditions

Lower Gastrointestinal Bleeding

Outcome Measures

Primary Outcomes (1)

• Endoscopic detection of colorectal polyps according to paris classification

  Paris Classification of Superficial GI Lesions Main Categories Type 0: Superficial Lesions Divided into 3 main types with subtypes: 1. Type 0-I: Protruded (Polypoid) 0-Ip (Pedunculated): Lesion is on a stalk (like a mushroom). 0-Is (Sessile): Broad-based elevation without a stalk. 2. Type 0-II: Non-Protruded, Non-Excavated (Flat) 0-IIa (Slightly Elevated): Slight elevation (less than 2.5 mm), often subtle. 0-IIb (Completely Flat): Same level as mucosa, hard to detect without special imaging (e.g., NBI). 0-IIc (Slightly Depressed): A shallow depression; higher risk for malignancy than IIa. 3. Type 0-III: Excavated (Ulcerated) True ulceration into the mucosa or deeper. Suggests deeper invasion and higher malignancy risk. Combined Morphologies Lesions can be mixed (e.g., 0-IIa + IIc, or 0-Is + IIa).

  Within 24 hours after endoscopy procedure

Study Arms (1)

Patients presented with lower GI bleeding

Patients presented with lower GI bleeding will be investigated with endoscopy to detect different findings

Device: Endoscopy

Interventions

Endoscopy DEVICE

Upper Endoscopy and colonoscopy will be used

Patients presented with lower GI bleeding

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Patients presents with lower gastrointestinal bleeding

You may qualify if:

• patients with hematochezia and melena. -

You may not qualify if:

• poor bowel preparation.
• Inco-operative patients.

Sponsors & Collaborators

• Assiut University: lead

MeSH Terms

Interventions

Endoscopy

Intervention Hierarchy (Ancestors)

Diagnostic Techniques, Surgical; Diagnostic Techniques and Procedures; Diagnosis; Minimally Invasive Surgical Procedures; Surgical Procedures, Operative

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Resident doctor

Study Record Dates

• First Submitted: June 27, 2025
• First Posted: July 18, 2025
• Study Start: July 25, 2025
• Primary Completion (Estimated): July 30, 2027
• Study Completion (Estimated): July 30, 2027
• Last Updated: July 18, 2025

Record last verified: 2025-07