Volume 118, Issue 1, Pages 197-200 (January 2000) American Gastroenterological Association medical position statement: Evaluation and management of occult and obscure gastrointestinal bleeding    Gastroenterology  Volume 118, Issue 1, Pages 197-200 (January 2000) DOI: 10.1016/S0016-5085(00)70429-X Copyright © 2000 Terms and Conditions

Fig. 1 Algorithm for evaluation of occult bleeding. *The indication and sequence of endoscopic procedures may be directed by patient age, symptoms, and comorbid conditions; small bowel biopsy is indicated at this juncture only in the presence of clinical or endoscopic evidence of celiac sprue. **Radiological studies may be indicated when comorbid conditions make endoscopy risky or when endoscopy is incomplete; small bowel follow-through radiographs have a very low yield unless clinical evidence exists for small bowel disease. Gastroenterology 2000 118, 197-200DOI: (10.1016/S0016-5085(00)70429-X) Copyright © 2000 Terms and Conditions

Fig. 2 Algorithm for evaluation of obscure bleeding. *The decision to repeat upper endoscopy and/or colonoscopy may depend on the skill and expertise of the initial endoscopist; push enteroscopy can replace upper endoscopy at this juncture; and small bowel biopsy is indicated in patients with clinical or endoscopic evidence of celiac sprue or unexplained IDA. **Repeat routine endoscopy may be performed in actively bleeding patients at the discretion of the endoscopist. ***Push enteroscopy and/or Sonde enteroscopy may be performed, depending on operator and institution expertise; enteroclysis can complement enteroscopy and improve the diagnostic yield. #Angiography performed electively may demonstrate typical findings of angiodysplasia or a tumor blush. Gastroenterology 2000 118, 197-200DOI: (10.1016/S0016-5085(00)70429-X) Copyright © 2000 Terms and Conditions