title: Long-term outcomes after double-balloon enteroscopy for obscure gastrointestinal bleeding.
abstract: OBJECTIVE
  Long-term outcomes after doubleballoon enteroscopy (DBE), performed for the evaluation of obscure gastrointestinal bleeding, have not been determined.
  
  
  METHODS
  We invited 274 patients undergoing DBE at Stanford University or the University of Chicago between 2004 and 2006 to participate in the study; 135 (49%) agreed (mean age, 64 +/- 14.8; range, 23-90 years). Telephone interviews were conducted at a mean of 11 and 30 months after DBE.
  
  
  RESULTS
  Arteriovenous malformations (AVMs) were detected in 43% of the cohort. One hundred one patients (37%; 56 with overt, 45 with occult bleeding) were interviewed 12 +/- 5 (range, 6-26) months after DBE. At 12 months, 43% reported no further overt bleeding or iron/transfusion needs, 23% reported overt bleeding, and 35% reported ongoing iron and/or transfusions. Eighty-five patients (31%) participated in the second survey, conducted 30 +/- 5.7 (range, 19-51) months after DBE. Fifty (59%) reported no overt bleeding or iron/transfusion needs, 20 (24%) reported overt bleeding, and 15 (18%) reported ongoing iron and/or transfusions. In the 40 patients evaluated after endoscopic treatment for AVMs, 17 (43%) reported no bleeding or iron therapy at 12 months and 16 of 29 (55%) at 30 months. Of the 40 patients with normal DBE examinations to the depth of insertion, 19 of 40 (48%) reported no bleeding or iron/transfusion needs at 12 months and 25 of 43 (58%) at 30 months.
  
  
  CONCLUSIONS
  At 30 months after DBE, up to 60% of patients report no further bleeding. Patients with AVMs or normal examinations to the depth of insertion are most likely to report recurrent hemorrhage.
authors.affiliation: Division of Gastroenterology and Hepatology, Stanford University, A149, 300 Pasteur Drive, Stanford, California 94305-5202, USA. lgerson@stanford.edu
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Gerson
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Batenic
authors.forename: Sharese L
authors.initials: SL
authors.lastname: Newsom
authors.forename: Andrew
authors.initials: A
authors.lastname: Ross
authors.forename: Carol E
authors.initials: CE
authors.lastname: Semrad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002641:Chicago; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult