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Suggest treatment for gastrointestinal bleeding

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Posted on Sat, 11 Apr 2015
Question: I am a 62 year old female with a history of digestive problems. Only serious one was a run of pancreatitis about 10 years ago. It was treated and have not had issues until the past 12-18 months. Apparently, I have an intestinal bleed somewhere. Has not yet been found. I've done endoscopy, colonoscopy, and camera pill. I've become anemic and have had 10+ iron infusions and with the last hemoglobin result of 7.5 I was given a blood transfusion. I am seeing both a hematologist/oncologist and gastroenterologist. 5 days ago I started with what I believed to be a stomach virus. On the 3rd day I went to the local ER for fluids and was released. Since that time I've had chronic diarrhea. I've been taking zofran and bentyl. Tomorrow I am scheduled for a double balloon enteroscopy. Hopefully, I can get that done inspite of the current issues going on. I have never had a definitive diagnosis for any of these issues. The best "guess" from the camera pill was gastritis. Really?
I live in the XXXXXXX area and have access to wonderful physicians and facilities. What do I do? I am miserable with myself.
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Answered by Dr. Ratnakar Kini (18 minutes later)
Brief Answer:
CT angiogram & Enteroscopy

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.

The thing to worry about is the low hemoglobin.
I presume it is an occult GI bleed and confirmed with a stool occult blood test.

Gastroscopy has ruled out bleeding source in esophagus, stomach and initial few centimeters of small intestine.
Colonsocopy has ruled out bleeding source in colon and probably the last few centimeters of the small intestine.

So what it left to be screened is the small intestine. Screening small bowel is a difficult thing.
Capsule endoscopy didnt reveal anything.
The options available to you are -
1. Enteroscopy
2. CT abdominal angiogram.

These two will reveal the bleeding source in the small intestine and appropriate treatment can be planned.

Let me know if you have any more questions.
Regards,
Dr.R.K.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ratnakar Kini (21 minutes later)
Thank you.....both test are on my "to do" list.
doctor
Answered by Dr. Ratnakar Kini (3 minutes later)
Brief Answer:
Welcome

Detailed Answer:
.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Ratnakar Kini

Gastroenterologist

Practicing since :1994

Answered : 2064 Questions

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Suggest treatment for gastrointestinal bleeding

Brief Answer: CT angiogram & Enteroscopy Detailed Answer: Hi, Thanks for posting your query. I am Dr.R.K and I am pleased to assist you. The thing to worry about is the low hemoglobin. I presume it is an occult GI bleed and confirmed with a stool occult blood test. Gastroscopy has ruled out bleeding source in esophagus, stomach and initial few centimeters of small intestine. Colonsocopy has ruled out bleeding source in colon and probably the last few centimeters of the small intestine. So what it left to be screened is the small intestine. Screening small bowel is a difficult thing. Capsule endoscopy didnt reveal anything. The options available to you are - 1. Enteroscopy 2. CT abdominal angiogram. These two will reveal the bleeding source in the small intestine and appropriate treatment can be planned. Let me know if you have any more questions. Regards, Dr.R.K.