Abstract
Acute episodes of lower GI bleeding normally generate attendance at hospital emergency departments and require admission depending on bleeding severity. The differential diagnoses are extensive so diagnosis can be challenging but modern radiological, endoscopic and medical techniques have transformed diagnosis, treatment and outcomes. In modern practice, very few patients presenting with acute lower gastrointestinal haemorrhage now require surgical intervention as endoscopic or interventional radiological techniques have high success rates. Outcomes depend more significantly on co-morbidities, especially for elderly patients on anticoagulant drugs, as well as the ease of access to early diagnostic and therapeutic facilities. This review outlines the evidence base for the diagnosis and optimal management of acute lower gastrointestinal bleeding with reference to modern national and international guidelines.