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Occult Small Bowel Bleeding

  • Colon (JC Anderson, Section Editor)
  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

Abstract

Purpose of review

This review sought to summarize the literature available on occult gastrointestinal (GI) bleeding within the small bowel, specifically.

Recent findings

Much of the recent research on this topic focuses on appropriate use of diagnostic modalities, including indications for, diagnostic yield of, and prognosis following capsule endoscopy, CT enteroscopy, and deep enteroscopy.

Summary

Overall, occult small bowel bleeding remains a relatively uncommon condition, defined as either positive fecal occult blood testing and/or iron deficiency anemia, without visible GI bleeding and following negative endoscopy. While vascular lesions are the most common etiology, the differential diagnosis is otherwise long. Few studies have focused on the diagnosis and treatment of occult bleeding specifically, and although the workup is similar to that of overt bleeding, the diagnostic/therapeutic yields are typically lower. As the risk for recurrent bleeding following appropriate endoscopic therapy remains significant, medical therapy—e.g., iron supplementation, RBC transfusion, somatostatin analogs, and/or thalidomide—does need to be considered in some cases, although additional prospective data will be helpful to better define its role. Surgical management should be reserved for those patients with severe and refractory disease.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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  1. Division of Gastroenterology & Hepatology, University of Connecticut Health, Farmington, CT, USA

    Perry K. Pratt Jr MD & Haleh Vaziri MD

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Pratt, P.K., Vaziri, H. Occult Small Bowel Bleeding. Curr Treat Options Gastro 19, 211–236 (2021). https://doi.org/10.1007/s11938-021-00337-y

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