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Although gastrointestinal bleeding complicates long- term oral anticoagulation therapy in up to 22 percent of patients, little is known about the etiology, evaluation, or outcome of bleeding episodes. In this retrospective review, more than 50 patients were identified over a 15-year period as having GI bleeding while receiving warfarin.
About half of all bleeding episodes occurred in the upper GI tract, and a lesion was identified in 81 percent of these cases (usually peptic ulcer disease). Lower GI tract bleeding occurred in one-third of the episodes, and lesions were identified in 52 percent of these cases; no diagnosis was established in the remaining patients with lower GI tract bleeding despite appropriate evaluation and follow-up for a…