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Management of Occult GI Bleeding pp 65–86Cite as

Esophagus

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Part of the book series: Clinical Gastroenterology ((CG))

Abstract

Esophageal occult bleeding represents an important subset of occult gastrointestinal (GI) bleeding. Gastroenterologists and primary care physicians need to be aware of the causes of esophageal bleeding, their presentations and how to manage these patients in timely and effective manner. The upper GI tract bleeding is estimated to account for 37% of occult GI bleeding with esophagitis alone accounting for 19%. The prevalence of reflux esophagitis cannot be determined accurately as many patients may be asymptomatic and some symptomatic patients may not seek medical attention due to mild symptoms. Esophageal carcinomas are also an important cause of occult GI bleeding. Particularly, patients with longstanding reflux esophagitis are predisposed to esophageal adenocarcinoma. It seems that a prolonged exposure to gastric acidity slowly transforms the mucosa in the lower third of the esophagus into a metaplastic, and later dysplastic tissue. Other primary esophageal malignancies can lead to occult bleeding. It is also important to recognize esophageal varices in cirrhotic patients. Esophageal varices usually present as melena or hematemesis. However, patients may have recurrent melena that goes unnoticed or is ignored by the patient and may present later with iron deficiency anemia. Esophageal causes of occult GI bleeding should be considered in patients with dysphagia, odynophagia, nausea, epigastric pain, atypical chest pain, heartburn, regurgitation, hiccups, chronic chough, hoarseness, sore throat, and unexplained weight loss.

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Authors and Affiliations

  1. Department of Internal Medicine, Albany Medical Center, Albany, NY, USA

    Omar Tageldin

  2. Albany Medical College, Albany, NY, USA

    Virali Shah

  3. Division of Gastroenterology, Albany Medical Center, Albany, NY, USA

    Neeha Kalakota & James Litynski

  4. Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA

    Hwajeong Lee

  5. Department of Gastroenterology and Hepatology, Albany Medical Center, Albany, NY, USA

    Micheal Tadros

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  1. Omar Tageldin
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  2. Virali Shah
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  3. Neeha Kalakota
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  4. Hwajeong Lee
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  5. Micheal Tadros
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  6. James Litynski
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Correspondence to James Litynski .

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Editors and Affiliations

  1. Department of Gastroenterology and Hepatology, Albany Medical Center, Albany, NY, USA

    Micheal Tadros

  2. Department of Internal Medicine, Division of Gastrenterology/Hepatology, University of Connecticut Health Center, Farmington, CT, USA

    George Y. Wu

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Tageldin, O., Shah, V., Kalakota, N., Lee, H., Tadros, M., Litynski, J. (2021). Esophagus. In: Tadros, M., Wu, G.Y. (eds) Management of Occult GI Bleeding. Clinical Gastroenterology. Humana, Cham. https://doi.org/10.1007/978-3-030-71468-0_5

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  • DOI: https://doi.org/10.1007/978-3-030-71468-0_5

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  • Online ISBN: 978-3-030-71468-0

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