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Endoscopic therapy of lower intestinal bleeding

	Probe diameter^¶	Coaptive pressure	Electrogenerator settings*		Desired outcome	Special features
	Probe diameter^¶	Coaptive pressure	Heater probe^¶	Bipolar probe^¶	Desired outcome	Special features
Angiodysplasia	Large^Δ	Light	10-15 J	10-15 W, 1 second pulses	Bleeding stops/angiodysplasia obliterated	Periphery of lesion treated before center; caution with right-sided lesions
Diverticulosis	Large^Δ	Light to moderate	10-15 J	15-20 W, 1-2 second pulses	Bleeding stops/visible vessel flat	Coaptive pressure may depend upon location (dome vs neck of diverticulum)
Postpolypectomy	Large^Δ	Light to moderate	10-20 J	15-20 W, 1-2 second pulses	Bleeding stops	Snaring (tamponade) of polyp stalk without current may be adequate for early bleeds

J: Joules; W: Watts
* Preinjection with epinephrine solution can be considered before endoscopic coagulation.
¶ Probe size, power settings, and coaptive pressure will necessarily vary depending on clinical experience and location of lesion. Repeated cautery to the same point increases risk of perforation.
Δ Large probe preferred if therapeutic endoscope used.

Adapted with permission from: Zuckerman G, Prakash C. Gastrointest Endosc 1999; 49:231.

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