Effect of push enteroscopy on transfusion requirements and quality of life in patients with unexplained gastrointestinal bleeding.

Abstract

The aim of our study was to determine whether push enteroscopy altered transfusion requirements or quality of life in patients with unexplained gastrointestinal bleeding. Twenty-nine patients with gastrointestinal bleeding unexplained by upper endoscopy and colonoscopy or persistent despite appropriate therapy after these procedures, underwent enteroscopy. Transfusion records in the year preceding and after the procedure were obtained from blood bank records and from telephone interviews every 6 months. Of 29 patients, 20 had received a transfusion (mean 8 +/- 3 units per patient) in the year preceding enteroscopy. In the year after the enteroscopy, 11 patients required transfusion (p = 0.034), and the mean transfusion requirement fell to 4 +/- 2 units, (p = 0.007). Angiodysplasia, the most frequent lesion found at enteroscopy (13 patients, 45%) were treated by endoscopic cautery. These patients had received an average of 13 +/- 6 units of packed cells per patient in the year preceding the procedure. In the year after enteroscopy, there was a significant reduction in transfusions (6 +/- 3 units per patient; p = 0.021). Of the 13 patients, 4 (31%) no longer required transfusions. Median functional status improved from 60 to 90 (p = 0.005). Enteroscopy alters the outcome of some patients with obscure gastrointestinal bleeding by reducing or eliminating bleeding and improving functional status.