Upper gastrointestinal bleeding classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

According to the American Gastroenterological Association, upper GI bleeding can be classified based on the rate of blood loss into overt(acute), occult or obscure(chronic) forms.

Classification

According to the American Gastroenterological Association (AGA), upper gastrointestinal bleeding can be classified based on the rate of blood loss into overt(acute), occult or obscure(chronic) forms.[1][2][3][4]

  • Occult or chronic GI bleeding: Occult GI bleeding is defined as a microscopic hemorrhage which can present as hemoccult-positive stools with or without iron deficiency anemia. It is the initial presentation in patients with no evidence of visible blood loss and is positive on fecal occult blood test(FOBT).
  • Obscure GI bleeding: Obscure GI bleeding is defined as recurrent bleeding in which a source is not identified after upper endoscopy and colonoscopy. It can be either overt or occult.
 
 
 
 
 
 
 
 
Upper GI bleeding
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Based on blood loss
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Overt
 
 
 
 
Occult
 
 
 
 
Obscure
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hematemesis
Coffee-ground emesis
Melena
Hematochezia
 
 
 
 
Microscopic hemorrhage
Heme-occult positive stools
 
 
 
 
Source is not identified

References

  1. "Non-variceal upper gastrointestinal haemorrhage: guidelines". Gut. 51 Suppl 4: iv1–6. 2002. PMC 1867732. PMID 12208839.
  2. Bull-Henry K, Al-Kawas FH (2013). "Evaluation of occult gastrointestinal bleeding". Am Fam Physician. 87 (6): 430–6. PMID 23547576.
  3. Raju GS, Gerson L, Das A, Lewis B (2007). "American Gastroenterological Association (AGA) Institute medical position statement on obscure gastrointestinal bleeding". Gastroenterology. 133 (5): 1694–6. doi:10.1053/j.gastro.2007.06.008. PMID 17983811.
  4. Rockey DC (1999). "Occult gastrointestinal bleeding". N. Engl. J. Med. 341 (1): 38–46. doi:10.1056/NEJM199907013410107. PMID 10387941.


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