- Deposiciones: color, frecuencia, duración (orienta a etiologia infecciosa, EII,,etc)
- Comorbilidades: Factores de riesgo cardiovascular, renal o hepático (tienen peor pronóstico)

Newman J, Fitzgerald JE, Gupta S, von Roon AC, Sigurdsson HH, Allen-Mersh TG. Outcome predictors in acute surgical ad- missions for lower gastrointestinal bleed- ing. Colorectal Dis 2012;14:1020-6.

- Medicación (AINES, antiagregantes, anticoagulantes)
- Antecedentes de HDA, cirugías abdominales, EII, radiación abdominopelviana
- Signos vitales, tacto rectal
- Ratio urea/creatinina > 30 sugiere sangrado alto

Srygley FD, Gerardo CJ, Tran T, Fisher DA. Does this patient have a severe upper gastrointestinal bleed? JAMA 2012;307: 1072-9.

- Prevención primaria: suspender AAS
- Prevención secundaria no suspender AAS. Si doble antiagregación suspender el antiagregante “no-AAS” No suspender doble antiagregación. Si el paciente tiene stent coronario dentro del mes o SCA dentro de los 3 meses previos: no suspender

Chan FKL, Leung Ki EL, Wong GLH, et al. Risks of bleeding recurrence and cardiovascular events with continued aspirin use after lower gastrointestinal hemorrhage. Gastroenterology 2016;151: 271-7.

Baigent C, Blackwell L, Collins R, et al. Aspirin in the primary and secondary pre- vention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 2009;373: 1849-60.

Bhatt DL, Scheiman J, Abraham NS, etal.ACCF/ACG/AHA2008expertconsen- sus document on reducing the gastroin- testinal risks of antiplatelet therapy and NSAID use. Am J Gastroenterol 2008;103: 2890-907.

Ho PM, Peterson ED, Wang L, et al. Incidence of death and acute myocardial infarction associated with stopping clopi- dogrel after acute coronary syndrome. JAMA 2008;299:532-9.

Eisenberg MJ, Richard PR, Libersan D, Filion KB. Safety of short-term discontin- uation of antiplatelet therapy in patients with drug-eluting stents. Circulation 2009; 119:1634-42.