Transcription of ACG Clinical Guideline: Diagnosis and …
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ACG Clinical Guideline: Diagnosis and …
Nature publishing group1265 2015 by the American College of Gastroenterology The American Journal of GASTROENTEROLOGYPRACTICE guidelines Bleeding from the small intestine remains a relatively uncom-mon event, accounting for ~5 10% of all patients presenting with gastrointestinal (GI) bleeding ( 1,2 ). Known previously as obscure GI hemorrhage (OGIB), we propose in this guideline that the former term referred to as OGIB be reclassifi ed as small bowel bleeding. Th e reason for this change in terminology is owing to the fact that the cause of bleeding can now be detected in the majority of patients given advances in small bowel imag-ing with video capsule endoscopy (VCE), deep enteroscopy, and radiographic imaging. Th e term OGIB would then be reserved for patients in whom a source of bleeding cannot be identifi ed anywhere in the GI tract and may represent a source of bleeding outside of the small bowel.
Gerson et al. The American Journal of GASTROENTEROLOGY VOLUME 110 | SEPTEMBER 2015 www.amjgastro.com 1266 Table 1 . Recommendation statements Diagnosis of small bowel bleeding 1. Second-look upper endoscopy should be considered in cases of recurrent hematemesis, melena, or a previously incomplete exam (strong …
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