Abstract
Objective: To identify common causes of lower gastrointestinal bleeding in our local population and to correlate with findings of previous studies.
Methodology: This cross-sectional descriptive study was carried out at Department of Gastroenterology, Lady Reading Hospital, Peshawar, from January 2016 to December 2017. A total of 546 patients who presented with lower GI bleeding were included in the study.
Results: Out of 546 patients, 210(38.4%) were males and 336(61.54%) females with a mean age of 40.3 years (range 3-87). Colonoscopy showed abnormalities in 423 (77.5%) patients. Among these, 183(33.52%) had hemorrhoids, which was the commonest cause of per rectal bleeding. Forty-six (8.43%) patients had rectal ulcer consistent with solitary rectal ulcers. Forty-three (7.9%) had mass at different site of colon and rectum, among which four patients had a non-traversable growth while 39 had a traversable growth. Seventy-nine (14.5%) patients had features consistent with inflammatory bowel disease. Forty-two (7.69%) had single polyp at different site while 12(2.2%) had multiple polyps. Arteriovenous malformations were found in 12(2.2%) patients. Six (1.1%) had diverticular disease and 123 (22.53%) had normal colonoscopy.
Conclusion: The leading cause of bleeding per rectum was hemorrhoids in this study, followed by inflammatory bowel disease, while diverticula and polyps were infrequent indicates that these are not common in this region.

Key words: Colonoscopy, lower gastrointestinal bleeding, polyps.