Several studies have shown that colonoscopy is safe and
effective when performed within 12 h of admission,
although two recent ones challenged the utility of early
colonoscopy [52, 53]. In their settings, urgent colonoscopy
had no advantage over expectant colonoscopy in terms of
diagnostic yield, subsequent therapy, hospital stay, and
overall clinical outcome. Thus, decisions concerning care
for patients with acute lower GI bleeding and the timing of
colonoscopy should be based on individual experience and
local expertise. It is our practice to perform colonoscopy
the morning after and after the patient is stabilized in the
intensive care unit (within 12–24 h of admission). If the
patient stops bleeding, colonoscopy is usually deferred for
48–72 h.