Colonoscopy is an integral diagnostic and therapeutic tool in the management of patients with lower gastrointestinal bleeding (LGIB). After resuscitation, reversal of coagulopathy, and exclusion of a proximal source of bleeding, colonoscopy should be performed in most patients with LGIB. Bowel preparation, typically with polyethylene glycol based solutions, is needed to closely inspect the colonic mucosa for bleeding sources. Colonoscopy within 24 h is recommended for high-risk patients with ongoing bleeding, although there is limited evidence that this strategy improves clinical outcomes. When active or stigmata of bleeding is detected, endoscopic intervention is indicated and can reduce future rebleeding. The most common options for endoscopic intervention include clipping, endoscopic band ligation, and coagulation, however rigorous head-to-head comparisons of different endoscopic tools are unavailable. Future research is needed to determine the optimal timing of colonoscopy, appropriate reversal strategies for patients on antithrombotics, and the most effective endoscopic hemostatic therapy.

中文翻译：

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结肠镜检查和内治疗在下消化道出血管理中的作用。

结肠镜检查是治疗下消化道出血（LGIB）患者的不可或缺的诊断和治疗工具。复苏，凝血病逆转和排除近端出血源后，大多数LGIB患者应进行结肠镜检查。通常需要用基于聚乙二醇的溶液进行肠准备，以仔细检查结肠粘膜的出血来源。对于有持续出血的高危患者，建议在24小时内进行结肠镜检查，尽管很少有证据表明该策略可改善临床结局。当检测到活动性或耻辱性出血时，表明有内镜干预，可减少将来的再出血。内窥镜干预最常见的选择包括钳夹，内窥镜带结扎和凝血，但是，无法对不同的内窥镜工具进行严格的头对头比较。需要进行进一步的研究以确定结肠镜检查的最佳时机，针对抗栓剂患者的适当逆转策略以及最有效的内镜止血疗法。