Small Bowel Bleeding

Gastrointestinal bleed is the most common diagnosis for GI-related inpatient admissions. Amongst the GI bleeds, about 50% are due to upper GI tract bleeds, 40% are due to lower GI tract bleeds, and about 5% to 10% are due to lesions in the small bowel. The small bowel is the part of the GI tract between the ligament of Treitz and the ileocecal valve. Small bowel bleeding can be divided into overt or occult. Patients are considered to have overt bleeding when they have visible bleeding, either melena or hematochezia. The bleeding is considered occult when there is no gross bleeding, but signs and symptoms of anemia, including fatigue, dyspnea, or palpitations, are present. Small bowel bleeding poses a significant diagnostic challenge for gastroenterologists. The clinical significance lies in the fact that most small bowel causes go undetected because the small bowel is long and hard to reach and therefore difficult to evaluate.