Factors predicting the presence of small bowel lesions in patients with obscure gastrointestinal bleeding.
OBJECTIVE
To identify the predictive factors for the presence of small bowel lesions in patients with obscure gastrointestinal bleeding (OGIB).


METHODS
A total of 242 patients with OGIB (overt 149: occult 93) were retrospectively included in the present study. Capsule endoscopy (CE) was carried out to investigate the small bowel, and detected lesions were classified according to the P0-P2 system. Only P2 lesions were defined as significant lesions. Univariate and multivariate logistic regression analyses were carried out to define the predictive factors for the presence of small bowel lesions.


RESULTS
In patients with overt OGIB, chronic kidney disease (CKD) ≥stage 4 (odds ratio [OR] 4.03; 95% confidence interval [CI] 1.45-11.1, P = 0.007) was identified as an independent predictor of the presence of vascular lesions, and a history of non-steroidalanti-inflammatory drug (NSAID) use as that of erosive/ulcerated lesions (OR 4.73; 95% CI 1.47-15.2, P = 0.009). However, in patients with occult OGIB, no significant predictors of the presence of vascular lesions were identified, whereas a history of low-dose aspirin (LDA) (OR 3.57; 95% CI 1.21-10.5, P = 0.02) and proton pump inhibitor (PPI) use (OR 3.18; 95% CI 1.02-9.92, P = 0.05) were identified as independent predictors of the presence of erosive/ulcerated lesions.


CONCLUSIONS
Our results indicated that bleeding pattern and clinical characteristics could contribute to predicting the origin of OGIB.
Gastroenterology Division, Yokohama City University School of Medicine, Yokohama, Japan.
Eiji
E
Sakai
Hiroki
H
Endo
Leo
L
Taniguchi
Yasuo
Y
Hata
Akiko
A
Ezuka
Hajime
H
Nagase
Eiji
E
Yamada
Hidenori
H
Ohkubo
Takuma
T
Higurashi
Yusuke
Y
Sekino
Tomoko
T
Koide
Hiroshi
H
Iida
Kunihiro
K
Hosono
Takashi
T
Nonaka
Hirokazu
H
Takahashi
Masahiko
M
Inamori
Shin
S
Maeda
Atsushi
A
Nakajima
D053704:Capsule Endoscopy / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007414:Intestinal Neoplasms / Q000150:complications / Q000175:diagnosis*; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies
capsule endoscopy (CE); low-dose aspirin (LDA); obscure gastrointestinal bleeding (OGIB); proton pump inhibitor (PPI); small bowel