A prospective study of same day bi-directional endoscopy in the evaluation of patients with occult gastrointestinal bleeding

Stray, Njaal; Weberg, R.

doi:10.1080/00365520500495789

Cited by 23 publications

(23 citation statements)

References 18 publications

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“…These results differ significantly from the previous U.S. studies in which gastric cancer was not detected and in all cases, the rates of colon cancer far exceeded those of gastric cancer [3, 5, 14, 16]. These previous studies mirror U.S. cancer registry data where colorectal cancer surpasses that of gastric cancer [10].…”

Section: Discussioncontrasting

confidence: 91%

“…This is higher in comparison to the previous literature with detection rates of 38% to 64% [3, 5, 8, 14–16]. Our low detection rate of clinically relevant lesions may be the result of several issues.…”

Section: Discussioncontrasting

confidence: 76%

“…Some researchers have advocated that only FOBT positive patients with iron deficiency anemia [8, 16] and/or upper GI symptoms [1, 5] should undergo EGD. For example, two GI societies contend that patients with occult blood loss and no anemia only require colonoscopy unless upper GI symptoms are present [17, 18].…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of gastric cancer versus colorectal cancer in Asians with a positive fecal occult blood test

Day

Cello

Somsouk

et al. 2011

Indian J Gastroenterol

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Aim Prior studies have reported conflicting results on the yield of esophagogastroduodenoscopy (EGD) in patients with a positive fecal occult blood test (FOBT). Our aim was to compare the yield between EGD and colonoscopy performed in a racially diverse population with a positive FOBT. Methods A retrospective, cross-sectional study of FOBT positive patients who underwent EGD and colonoscopy from January 1, 1999 to November 1, 2008. Endoscopic lesions deemed responsible for GI bleeding were identified. Results Two hundred and eighty-seven patients met entry criteria, among which, 63% were Asian and 81% were immigrants to the U.S. Forty-four patients had EGD findings deemed responsible for a positive FOBT, the most common being esophagitis (25.0%) and gastric ulceration (15.9%). Forty-two patients had colonoscopic findings likely responsible for a positive FOBT with the most frequent lesion being colonic polyps ≥9 mm in diameter (76.2%). Prevalence of lower and upper GI tract lesions responsible for positive FOBT was similar (14.6% vs. 15.3%, p=0.2). There was no association between a patient reporting upper GI symptoms, or the presence of anemia and the detection of upper GI tract lesions on endoscopy. Gastric adenocarcinoma (n=3) was as prevalent as colorectal adenocarcinoma (n=4). All three patients with gastric adenocarcinomas were Asian (prevalence 1.6%). Conclusions In our racially diverse population evaluated for a positive FOBT, gastric adenocarcinoma was as prevalent as colorectal adenocarcinoma; however, gastric adenocarcinoma was limited to Asian patients. EGD and colonoscopy should be considered in the evaluation of patient populations similar to ours, particularly Asian immigrants.

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Section: Discussioncontrasting

confidence: 91%

Section: Discussioncontrasting

confidence: 76%

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Prevalence of gastric cancer versus colorectal cancer in Asians with a positive fecal occult blood test

Day

Cello

Somsouk

et al. 2011

Indian J Gastroenterol

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“…10,11 Some studies showed that evaluation of the upper gastrointestinal tract helped to identify important lesions in symptomatic patients and those with iron deficiency anemia; 12,13 however, others concluded that esophagogastroduodenos copy was unjustified because important findings in the upper gastrointestinal tract were rare [14][15][16][17] and sometimes irrelevant to the results of fecal occult blood testing. [18][19][20][21] This controversy is re lated to the heterogeneity of study populations and to the limitations of the formerly used guaiac-based fecal occult blood test, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] which was not able to distinguish bleeding in the lower gastrointestinal tract from that originating in the upper tract.…”

mentioning

confidence: 99%

Performance of the immunochemical fecal occult blood test in predicting lesions in the lower gastrointestinal tract

Chiang¹,

Lee²,

Tu³

et al. 2011

Canadian Medical Association Journal

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“…In the case of the simulated patient with occult gastrointestinal blood loss, the frequency of endoscopic findings was based on published literature estimates of the diagnostic yield of EGD in identifying a bleeding source in patients with fecal occult blood loss [23–26]. Suitable estimates of the diagnostic yield of EGD in a cohort restricted to recent AMI and fecal occult blood could not be identified in the published literature.…”

Section: Methodsmentioning

confidence: 99%

Upper Endoscopy in Patients with Acute Myocardial Infarction and Upper Gastrointestinal Bleeding: Results of a Decision Analysis

Yachimski

Hur

2008

Dig Dis Sci

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Background The management of patients with acute myocardial infarction (AMI) and upper gastrointestinal bleeding (UGIB) can present a challenge. The utility of upper endoscopy (esophagogastroduodenoscopy, EGD) and endoscopic therapy must be weighed against safety considerations. Aim To assess the utility and safety of EGD in patients with UGIB and AMI. Methods Using decision analysis, patients with UGIB and AMI were assigned to one of two strategies: (1) EGD prior to cardiac catheterization (EGD strategy) and (2) cardiac catheterization without EGD (CATH strategy). Results In patients with overt UGIB, the EGD strategy resulted in 97 deaths per 10,000 patients, compared with 600 deaths in the CATH strategy. The EGD strategy resulted in fewer non-fatal complications (1,271 vs. 6,000 per 10,000 patients). In patients with occult blood loss, the EGD strategy resulted in more deaths (59 vs. 16 per 10,000) and more non-fatal complications (888 vs. 160 per 10,000) than the CATH strategy. Conclusions Our analysis supports EGD prior to cardiac catheterization in patients with AMI and overt UGIB. This strategy results in fewer deaths and complications compared with a strategy of proceeding directly to catheterization. Our analysis does not support routine EGD prior to cardiac catheterization in patients with fecal occult blood.

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A prospective study of same day bi-directional endoscopy in the evaluation of patients with occult gastrointestinal bleeding

Cited by 23 publications

References 18 publications

Prevalence of gastric cancer versus colorectal cancer in Asians with a positive fecal occult blood test

Prevalence of gastric cancer versus colorectal cancer in Asians with a positive fecal occult blood test

Performance of the immunochemical fecal occult blood test in predicting lesions in the lower gastrointestinal tract

Upper Endoscopy in Patients with Acute Myocardial Infarction and Upper Gastrointestinal Bleeding: Results of a Decision Analysis

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