Review
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World J Gastrointest Pathophysiol. Nov 15, 2014; 5(4): 523-533
Published online Nov 15, 2014. doi: 10.4291/wjgp.v5.i4.523
Continuing challenges in the diagnosis and management of obscure gastrointestinal bleeding
Veronica Baptista, Neil Marya, Anupam Singh, Abbas Rupawala, Bilal Gondal, David Cave
Veronica Baptista, Neil Marya, Anupam Singh, Abbas Rupawala, Bilal Gondal, David Cave, Department of Medicine, University of Massachusetts Memorial Medical Center, Worcester, MA 01655, United States
David Cave, Gastroenterology Division, UMass Memorial Medical Center, Worcester, MA 01655, United States
Author contributions: All the authors contributed to the writing, editing and reviewing of the paper.
Correspondence to: David Cave, MD, PhD, Professor of Medicine, Gastroenterology Division, UMass Memorial Medical Center, 55 Lake Avenue North, Worcester, MA 01655, United States. david.cave@umassmemorial.org
Telephone: +1-508-8568399 Fax: +1-508-8563981
Received: January 22, 2014
Revised: July 7, 2014
Accepted: July 17, 2014
Published online: November 15, 2014
Abstract

The diagnosis and management of obscure gastrointestinal bleeding (OGIB) have changed dramatically since the introduction of video capsule endoscopy (VCE) followed by deep enteroscopy and other imaging technologies in the last decade. Significant advances have been made, yet there remains room for improvement in our diagnostic yield and treatment capabilities for recurrent OGIB. In this review, we will summarize the latest technologies for the diagnosis of OGIB, limitations of VCE, technological enhancement in VCE, and different management options for OGIB.

Keywords: Obscure gastrointestinal bleeding, Video capsule endoscopy, Deep enteroscopy, Computed tomography enterography, Magnetic resonance enterography

Core tip: Since the advent of capsule endoscopy, significant advances have been made in the imaging of the small bowel that allow for the diagnosis and management of obscure gastrointestinal bleeding. With a decade of knowledge, it is now appropriate for us to look back, critically evaluate our achievements, improve on our current technologies and develop ideas to circumvent some of the shortcomings.