Repeated esophagogastroduodenoscopy and colonoscopy in the diagnosis of gastrointestinal bleeding
2025-03-11
(Press-News.org)
Gastrointestinal (GI) bleeding is a common and potentially life-threatening condition that requires prompt and accurate diagnosis. Esophagogastroduodenoscopy (EGD) and colonoscopy are the primary diagnostic modalities, but initial examinations may sometimes fail to identify the bleeding source. In such cases, repeated endoscopic evaluations can improve detection rates. This review explores the role of repeat EGD and colonoscopy in diagnosing GI bleeding, highlighting the conditions under which they are most beneficial and the challenges associated with their use.
Incidence and Causes of Gastrointestinal Bleeding
GI bleeding is classified into upper, middle, and lower GI bleeding based on the site of hemorrhage. Acute upper GI bleeding has an incidence of 84–160 cases per 100,000 individuals annually, with a 10% mortality rate. Peptic ulcers, variceal bleeding, and mucosal erosions are among the most common causes. Lower GI bleeding, with an incidence of 20–33 cases per 100,000 individuals, is frequently caused by diverticular disease, hemorrhoids, malignancies, and colitis. The diagnostic accuracy of EGD for upper GI bleeding is approximately 90–95%, whereas colonoscopy for lower GI bleeding has a diagnostic rate of 48–90%.
Role of Repeated EGD and Colonoscopy
Certain conditions, such as Dieulafoy’s disease, intermittent bleeding, and limited visualization during initial endoscopy, may necessitate repeated examinations. Repeated EGD has been shown to enhance lesion detection, particularly in cases where the initial examination is inconclusive due to active bleeding or poor visualization. Similarly, repeated colonoscopy is valuable for detecting colonic diverticular bleeding and assessing recurrent hemorrhages.
Indications for Repeat Endoscopy
Repeated EGD and colonoscopy should be considered in the following scenarios:
Poor Visualization During Initial Endoscopy - Blood clots, food residue, or inadequate bowel preparation can obscure lesions.
Incomplete Initial Examination - If the first procedure does not achieve full visualization of the GI tract.
Recurrent or Persistent Bleeding - Clinical evidence of ongoing hemorrhage may indicate a missed lesion.
Additional Imaging Suggests a Bleeding Source Within Endoscopic Reach - Findings from capsule endoscopy or CT angiography can guide repeat procedures.
Optimizing the Utility of Repeated Endoscopy
To minimize the need for repeat procedures, proper bowel preparation, experienced endoscopists, and advanced imaging modalities should be employed. Scheduling endoscopic examinations at appropriate times, particularly within 24 hours for high-risk patients, enhances diagnostic yield. Emerging technologies, such as water-jet-assisted colonoscopy and cap-assisted endoscopy, improve visualization and lesion detection rates.
Conclusions
Repeated EGD and colonoscopy play a critical role in diagnosing GI bleeding when initial examinations fail to identify the bleeding source. While routine repeat procedures are not always necessary, careful patient selection based on clinical factors can enhance diagnostic accuracy and improve patient outcomes. Further research is needed to establish standardized guidelines for repeat endoscopy in GI bleeding management.
Full text
https://www.xiahepublishing.com/2994-8754/JTG-2024-00024
The study was recently published in the Journal of Translational Gastroenterology.
Journal of Translational Gastroenterology (JTG) dedicates to improving clinical diagnosis and treatment, advancing understanding of the molecular mechanisms, and promoting translation from bench to bedside of gastrointestinal, hepatobiliary, and pancreatic diseases. The aim of JTG is to provide a forum for the exchange of ideas and concepts on basic, translational, and clinical aspects of gastroenterology, and promote cross-disciplinary research and collaboration.
Follow us on X: @xiahepublishing
Follow us on LinkedIn: Xia & He Publishing Inc.
END
ELSE PRESS RELEASES FROM THIS DATE:
2025-03-11
PHILADELPHIA – Since 2017, firearm-related injuries in the United States have been the most common cause of death from injury among children through young adults, ages 1 to 24, surpassing motor vehicle accidents, according to a 2022 study. Access to firearms in one’s home increases the risk of suicide and accidental death.
But over a third of Americans with guns in their homes say they do not store all of them in a locked location (37%), according to the latest health survey from the Annenberg Public Policy Center (APPC) of the University of Pennsylvania. ...
2025-03-11
“Environmental exposures may cause genetic damage, lead to mutations in key genes, and/or block the DNA repair mechanisms increasing the risk of cancer.”
BUFFALO, NY – March 11, 2025 – A new editorial was published in Oncotarget, Volume 16, on March 10, 2025, titled “EXPOSOMES and GENES: The duo influencing CANCER initiation and progression.”
In this editorial, Drs. Uzma Saqib, Katherine E. Ricks, Alexander G. Obukhov, and Krishnan Hajela from Devi Ahilya Vishwavidyalaya (DAVV) in Indore, India, discuss how environmental factors, known as exposomes, interact with genes to influence cancer risk. The authors highlight how pollution, diet, ...
2025-03-11
A recent study published in Engineering delves into the complex impacts of elevated CO2 levels on food security, plant growth, and crop quality. As the global atmospheric CO2 concentration continues to rise, understanding these effects is crucial for ensuring future food supplies.
On one hand, elevated CO2 can have some positive effects on plants. For C3 plants, it can stimulate photosynthesis, leading to increased dry matter yield and grain production. In legumes, it enhances N2 fixation, which is beneficial for reducing reliance on chemical fertilizers. Additionally, ...
2025-03-11
Researchers from RMIT University and the University of Melbourne have discovered that water generates an electrical charge up to 10 times greater than previously understood when it moves across a surface.
The team, led by Dr Joe Berry, Dr Peter Sherrell and Professor Amanda Ellis, observed when a water droplet became stuck on a tiny bump or rough spot, the force built up until it “jumped or slipped” past an obstacle, creating an irreversible charge that had not been reported before.
The new understanding of this “stick-slip” motion of water over a surface paves the way for surface design with controlled electrification, with ...
2025-03-11
Miami (March 11, 2025) – People with chronic obstructive pulmonary disease (COPD) and arthritis have a higher risk of death than people with arthritis who do not have COPD, according to a new study. The study is published in the January 2025 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, a peer-reviewed, open-access journal.
COPD is an inflammatory lung disease, comprising several conditions, including chronic bronchitis and emphysema, and can be caused by genetics and irritants like smoke or pollution. The disease affects more than 30 million Americans and is the fourth leading cause of death ...
2025-03-11
WASHINGTON, DC – The Editorial Board of the Proceedings of the National Academy of Sciences (PNAS) has selected six papers published by PNAS in 2024 to receive the Cozzarelli Prize, an award that recognizes outstanding contributions to the scientific disciplines represented by the National Academy of Sciences (NAS). Papers were chosen from more than 3,200 research articles that appeared in the journal last year and represent the six broadly defined classes under which the NAS is organized. Additionally, the Editorial Board has recognized six papers—one ...
2025-03-11
The American Meteorological Society continuously publishes research on climate, weather, and water in its 12 journals. Many of these articles are available for early online access–they are peer-reviewed, but not yet in their final published form. Below are some recent examples.
JOURNAL ARTICLES
Climate Change Increases Energy Demand and Cost in Texas
Weather, Climate, and Society
Climate change is driving large increases in electricity demand and costs in Texas’ ERCOT market. Compared to a 1950–1980 baseline climate, ERCOT electricity demand in 2023 was 1.9 ...
2025-03-11
Written by Jessica Colarossi
Microplastics—tiny shards of plastic debris—are all over the planet. They have made their way up food chains, accumulated in oceans, clustered in clouds and on mountains, and been found inside our bodies at alarming rates. Scientists have been racing to uncover the unforeseen impacts of so much plastic in and around us.
One possible, and surprising, consequence: more drug-resistant bacteria.
In a startling discovery, a team of Boston University researchers found that bacteria exposed to microplastics became resistant to multiple types of antibiotics commonly used to treat infections. They ...
2025-03-11
Washington, D.C.—Microplastics are not just pollutants, but also highly complex materials that facilitate antimicrobial resistance, even without antibiotics, according to a new study. The findings were published in Applied and Environmental Microbiology, a journal of the American Society for Microbiology.
“Addressing plastic pollution isn’t just an environmental issue—it’s a critical public health priority in the fight against drug-resistant infections,” said lead study author Neila Gross, a Ph.D. candidate in the lab of Professor Muhammad ...
2025-03-11
WASHINGTON—Endocrine Society members elected Nanette Santoro, M.D., of the University of Colorado School of Medicine in Aurora, Colo., as its 2026-2027 President. She will serve as President-Elect for a year beginning in July 2025 before becoming President in June 2026.
Santoro has served as E. Stewart Taylor Chair of Obstetrics & Gynecology at the University of Colorado School of Medicine since 2010. She is a well-recognized practitioner, dedicated mentor and leading researcher on studies of women with premature and age-appropriate menopause.
She has held many roles with the Endocrine Society, including serving as Vice President of Clinical Science, an author ...
LAST 30 PRESS RELEASES:
[Press-News.org] Repeated esophagogastroduodenoscopy and colonoscopy in the diagnosis of gastrointestinal bleeding
