“Small bowel bleeding” should replace the classification of “obscure gastrointestinal bleeding,” because advances in imaging the small intestine mean it’s usually possible to identify the source of bleeding, according to American College of Gastroenterology new practice guidelines on the diagnosis and management of small bowel bleeding, which were published online August 25 in the American Journal of Gastroenterology (and published in the September print issue).
“Traditionally, when patients with GI bleeding underwent an upper and lower endoscopy without identification of a bleeding source, they were labeled as having obscure GI bleeding,” said one of the guideline authors Dr. Lauren Gerson of California Pacific Medical Center in San Francisco, in a Sept. 8 Reuters Health article. Read the full news story
The new ACG guideline reviews the definition, epidemiology, causes of small bowel bleeding, and therapeutic options. The guideline also provides a review of diagnostic modalities for patients with small bowel hemorrhage including VCE, endoscopic evaluation with push and/or deep enteroscopy, and radiographic modalities including cross-sectional imaging (computed tomography (CT) and magnetic resonance (MR)) enterography, angiography, and scintigraphy. Treatment approaches are reviewed as endoscopic, medical, and surgical options.