SynthesisClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2020
Early Colonoscopy Does Not Improve Outcomes of Patients With Lower Gastrointestinal Bleeding: Systematic Review of Randomized Trials.
Synthesis in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 51 citations in OpenAlex.
- Updated evidence on epidemiology, diagnosis, and treatment for colonic diverticular bleeding.DEN open · 2026Review
- Comprehensive review on the current management of lower-gut bleed.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Review
- Gastrointestinal complications in intensive care.Medical review (2021) · 2025Review
- Article
- Diagnostic Role of Radiology in Acute Gastrointestinal Bleeding: A Comprehensive Review.Cureus · 2025Review
- Early Versus Late Bowel Preparation for Suspected Acute Diverticular Bleeding: A Retrospective Study.Cureus · 2025Article
- Management of gastrointestinal bleed in the intensive care setting, an updated literature review.World journal of critical care medicine · 2025Review
- Empiric embolization by vasospasm therapy for acute lower gastrointestinal bleeding: a preliminary report.Scientific reports · 2024Article
- Early double-balloon enteroscopy was not related to better clinical outcomes in patients with suspected overt small bowel bleeding.Journal of the Chinese Medical Association : JCMA · 2024Article
- Utility of early colonoscopy for acute lower gastrointestinal bleeding: a retrospective cohort study.Therapeutic advances in gastroenterology · 2023Article
- Article
- American College of Gastroenterology-Canadian Association of Gastroenterology Clinical Practice Guideline: Management of Anticoagulants and Antiplatelets During Acute Gastrointestinal Bleeding and the Periendoscopic Period.Journal of the Canadian Association of Gastroenterology · 2022Review
- Assessment of Video Capsule Endoscopy in the Management of Acute Gastrointestinal Bleeding During the COVID-19 Pandemic.JAMA network open · 2021Article
- Updating the recommendations on bowel preparation for acute lower gastro-intestinal bleeding: The time has come!Endoscopy international open · 2021Article
- Trends in hospitalization, mortality, and timing of colonoscopy in patients with acute lower gastrointestinal bleeding.Endoscopy international open · 2021Article
- AGA Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic.Gastroenterology · 2020Review
- Donning a New Approach to the Practice of Gastroenterology: Perspectives From the COVID-19 Pandemic Epicenter.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2020Review
- Indications for Gastrointestinal Endoscopy during the COVID-19 Pandemic.Journal of digestive endoscopy · 2020Review
- Diagnosis and Management of Non-Variceal Gastrointestinal Hemorrhage: A Review of Current Guidelines and Future Perspectives.Journal of clinical medicine · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND &
aimsGuidelines recommend colonoscopy evaluation within 24 hours of presentation or admission in patients with high-risk or severe acute lower gastrointestinal bleeding (LGIB). Meta-analyses of the timing of colonoscopy have relied primarily on observational studies that had major potential for bias. We performed a systematic review of randomized trials to determine optimal timing of colonoscopy for patients hospitalized with acute LGIB.
methodsWe searched publication databases through July 2019 and abstracts from gastroenterology meetings through November 2019 for randomized trials of patients with acute LGIB or hematochezia. We searched for studies that compared early colonoscopy (within 24 hours) with elective colonoscopy beyond 24 hours and/or other diagnostic tests. Our primary outcome was further bleeding, defined as persistent or recurrent bleeding after index examination. Secondary outcomes included mortality, diagnostic yield (identifying source of bleeding), endoscopic intervention, and any primary hemostatic intervention (endoscopic, surgical, or interventional radiologic). We performed dual independent review, data extraction, and risk of bias assessments. We performed the meta-analysis using a random-effects model.
resultsOur final analysis included data from 4 randomized trials. Further bleeding was not decreased among patients who received early vs later, elective colonoscopy (relative risk [RR] for further bleeding with early colonoscopy, 1.57; 95% CI. 0.74-3.31). We did not find significant differences in the secondary outcomes of mortality (RR, 0.93; 95% CI, 0.05-17.21), diagnostic yield (RR, 1.09; 95% CI, 0.99-1.21), endoscopic intervention (RR, 1.53; 95% CI, 0.67-3.48), or any primary hemostatic intervention (RR, 1.33; 95% CI, 0.92-1.92).
conclusionsIn a meta-analysis of randomized trials, we found that colonoscopy within 24 hours does not reduce further bleeding or mortality in patients hospitalized with acute LGIB. Based on these findings, patients hospitalized with acute LGIB do not generally require early colonoscopy.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.