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Comparison of Risk Factors Between Small Intestinal Ulcerative and Vascular Lesions in Occult Versus Overt Obscure Gastrointestinal Bleeding

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Abstracts

Background and Aims

The detailed risk factors such as bleeding pattern, comorbidities, and medication usage of patients with obscure gastrointestinal bleeding (OGIB) are largely unknown. We evaluated the risk factors related to ulcerative and vascular lesions of the small intestine diagnosed by capsule endoscopy or balloon-assisted endoscopy in OGIB cases.

Methods

We retrospectively evaluated 390 OGIB cases (occult, n = 101; overt, n = 289) in our hospital between January 2005 and March 2011 using univariate and multivariate logistic regression analyses to determine the related risk factors.

Results

In occult (n = 36) and overt (n = 120) OGIB cases, some lesions were detected in the small intestine. Ulcerative and vascular lesions were detected in both occult (n = 25, 69.4 %; n = 8, 22.2 %, respectively) and overt (n = 57, 47.5 %; n = 39, 32.5 %, respectively) cases. For ulcerative lesions, non-steroidal anti-inflammatory drugs were identified as a risk factor in overt cases [odds ratio (OR) 2.974, 95 % confidence interval (CI) 1.522–5.809, P = 0.001]. For vascular lesions, lowest hemoglobin level (OR 0.634, 95 % CI 0.422–0.953, P = 0.028) and hematologic disease (OR 8.575, 95 % CI 1.076–68.309, P = 0.042) were identified as risk factors in occult cases, whereas hemodialysis (OR 3.71, 95 % CI 1.315–10.467, P = 0.013) was identified in overt cases. Additionally, liver cirrhosis was noted as a risk factor in both occult (OR 7.453, 95 % CI 1.213–45.773, P = 0.013) and overt (OR 4.900, 95 % CI 2.099–11.443, P < 0.001) OGIB cases.

Conclusion

There are differences in risk factors related to ulcerative versus vascular lesions in the small intestine in occult and overt OGIB cases. Differences were seen in both medication usage and comorbidities.

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Authors and Affiliations

  1. Department of Gastroenterology, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Junichi Okamoto, Kazunari Tominaga, Satoshi Sugimori, Kunihiro Kato, Hiroaki Minamino, Masaki Ominami, Shusei Fukunaga, Yasuaki Nagami, Noriko Kamata, Hirokazu Yamagami, Tetsuya Tanigawa, Masatsugu Shiba, Toshio Watanabe, Yasuhiro Fujiwara & Tetsuo Arakawa

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  1. Junichi Okamoto
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  2. Kazunari Tominaga
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  3. Satoshi Sugimori
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  4. Kunihiro Kato
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  5. Hiroaki Minamino
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  15. Tetsuo Arakawa
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Corresponding author

Correspondence to Kazunari Tominaga.

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Conflict of interest

Tetsuo Arakawa has participated in advisory committees for Otsuka Pharmaceutical Co. Ltd. and Eisai Co. Ltd. Yasuhiro Fujiwara has participated in advisory committees for Eisai Co. Ltd. All other authors declare that they have no conflicts of interest.

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Okamoto, J., Tominaga, K., Sugimori, S. et al. Comparison of Risk Factors Between Small Intestinal Ulcerative and Vascular Lesions in Occult Versus Overt Obscure Gastrointestinal Bleeding. Dig Dis Sci 61, 533–541 (2016). https://doi.org/10.1007/s10620-015-3904-5

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  • DOI: https://doi.org/10.1007/s10620-015-3904-5

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