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Factors predicting the presence of small bowel lesions in patients with obscure gastrointestinal bleeding
Author(s) -
Sakai Eiji,
Endo Hiroki,
Taniguchi Leo,
Hata Yasuo,
Ezuka Akiko,
Nagase Hajime,
Yamada Eiji,
Ohkubo Hidenori,
Higurashi Takuma,
Sekino Yusuke,
Koide Tomoko,
Iida Hiroshi,
Hosono Kunihiro,
aka Takashi,
Takahashi Hirokazu,
Inamori Masahiko,
Maeda Shin,
Nakajima Atsushi
Publication year - 2013
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12002
Subject(s) - medicine , odds ratio , capsule endoscopy , gastroenterology , confidence interval , aspirin , obscure gastrointestinal bleeding , logistic regression , occult , gastrointestinal bleeding , pathology , alternative medicine
Aim 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 .