Gastroenterology Book

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Gastrointestinal Occult BleedingAka: Occult Gastrointestinal Bleeding

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  1. See Also
    1. Gastrointestinal Bleeding
  2. Diagnosis
    1. See Fecal Occult Blood
  3. Causes
    1. See Occult Gastrointestinal Bleeding Causes
  4. Approach
    1. Overt or visible bleeding
      1. See Gastrointestinal Bleeding
    2. Step 1: Upper and Lower endoscopy
      1. Indications to start with lower endoscopy
        1. Age over 50 years
      2. Indications to start with upper endoscopy
        1. Age under 50 years
        2. Significant NSAID use
        3. Alcohol Abuse
    3. Step 2: Approach to negative endoscopy
      1. Active, overt bleeding
        1. Tagged Red Cell Scan (helpful in brisk bleeding) or
        2. Angiography
      2. No active bleeding
        1. Repeat endoscopy
    4. Step 3: Small bowel evaluation
      1. Evaluate if endoscopy does not reveal source
  5. References
    1. Rockey in Feldman (2002) Sleisenger GI, p. 232-48
    2. Leighton (2003) Gastrointest Endosc 58(5):650
    3. Mitchell (2004) Am Fam Physician 69(4):875

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