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Upper gastrointestinal bleed

Prevalence
Causes
Clinical features
Investigations
Therapy
Prevention
Prognosis
Clinical features

Perform a rectal examination d and a faecal occult blood test. a

Why?

A positive faecal occult blood test makes a gastrointestinal bleed more likely

Patient Target Disorder and
Reference Standard		 Diagnostic Test LR+
(95% CI) 		Post-test Probability LR-
(95% CI) 		Post-test Probability
iron-deficiency anaemia a
(pre-test probability: 19%) 		probable GI bleed
(gastroscopy, colonoscopy) 		guaiac occult blood test 2.6
(1.8 to 3.6) 		37% 0.39
(0.22 to 0.69) 		8%
 

Note:

  • Epigastric tenderness does not help diagnose peptic ulcer disease b

Expiry date: July 2003
Levels of Evidence used in grading these guides

Author   A   Townsend , CM   Ball
Reviewer   L   Friedman
CAT Writers   A   Townsend , CM   Ball , CJ   Wotton