Yield of Upper Endoscopy in the Evaluation of Asymptomatic Patients with Hemoccult‐Positive Stool after a Negative Colonoscopy

Patricia C. Hsia, Firas H. Al‐Kawas

Research output: Contribution to journalArticle

Abstract

The yield of upper endoscopy in asymptomatic patients with positive fecal occult blood test (FOBT) and a negative colonoscopy was evaluated prospectively in 70 consecutive patients. Significant pathology was diagnosed in 19 patients (27%), eight patients with ulcers, five with arteriovenous malformations, three with esophageal or gastric varices, two with multiple erosions, and two with biopsy‐proven Barrett's esophagus. Thirteen patients had iron deficiency anemia and demonstrated a 38% prevalence of significant pathology. Fifteen patients on nonsteroidal anti‐inflammatory agents had a 30% prevalence of significant pathology. No statistically significant difference was noted between subgroups. In conclusion, asymptomatic patients without a colonic source to explain a positive FOBT often have significant lesions, on upper endoscopy. Iron deficiency anemia did not have an impact on pathology. Because treatment and follow‐up plans were altered in many of the cases in which significant pathology was demonstrated, we conclude that upper endoscopy should be seriously considered for all asymptomatic patients with occult gastrointestinal bleeding and a negative colonoscopic examination.

Original languageEnglish (US)
Pages (from-to)1571-1574
Number of pages4
JournalThe American Journal of Gastroenterology
Volume87
Issue number11
DOIs
StatePublished - Nov 1992
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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