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Obscure gastrointestinal bleeding (OGIB) is defined as documented bleeding from the GI tract with no etiology identified after upper endoscopy and colonoscopy. OGIB can be frustrating for both the physician and the patient because multiple modalities are available for identifying small GI bleeding sources, but none is ideal.
To identify the optimal approach for managing OGIB, investigators performed a cost-minimization analysis comparing five strategies: small-bowel follow-through, enteroclysis, push enteroscopy (PE), capsule endoscopy (CE), and double-balloon endoscopy (DBE). Data on the sensitivity of each test were obtained from the literature. Actual costs, not charges, were used in the analysis. Tests were assumed to be used sequentiall…