Endoscopic hemostasis should be attempted with a
3.7–4.2-mm large-channel colonoscope to allow blood and
colon content to be suctioned through the working channel
alongside an accessory. Alternatively, a double-channel
colonoscope can be used when available, which enables
accessories manipulation independently from aspiration.
The data show that careful early colonoscopy is highly
effective for both the diagnosis (sensitivity of proximally
86%, ranging from 48 to 90%) and therapeutic intervention
of patients with severe lower GI bleeding [51–54]. Early
colonoscopy is also associated with a shorter hospital stay
and it is more cost-effective (cost saving of approximately
$10,000 per patient) than other strategies for the diagnosis
and treatment of severe hematochezia [47, 50–53].