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61/no. viagra dosage 150 11(june 1, 2000) june 1, 2000 table of contents tips from other journals causes of occult and obscure gastrointestinal bleeding am fam physician.
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â 2000â junâ 1;61(11):3398-3400. buy viagra 5mg canada It is common for patients to present with occult or obscure gastrointestinal bleeding, but meaningful diagnostic criteria have not been delineated for either type of bleeding. viagra viagra viagra unterschied Occult gastrointestinal bleeding refers to the initial presentation of a patient with a positive fecal occult blood test (fobt) and/or iron deficiency anemia (ida), without visible fecal blood. where to buy viagra tablets Obscure bleeding is defined as bleeding of unknown origin that persists or recurs after negative initial or primary endoscopic evaluation (colonoscopy or upper endoscopy).
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The clinical practice and practice economics committee of the american gastroenterological association (aga) reviewed the literature and developed recommendations for the evaluation and treatment of occult and obscure gastrointestinal bleeding.
This discussion is limited to their recommendations for the evaluation of bleeding.
The bedside examination may be helpful in providing clues to the cause of bleeding.
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A history can reveal ingestion of medications known to cause bleeding (e. where to buy viagra tablets G.
, aspirin, nonsteroidal anti-inflammatory drugs, alendronate, potassium chloride, anticoagulants).
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A family history might suggest a hereditary vascular problem. where to buy viagra tablets Other rare causes of bleeding may be detected on physical examination, including plummer-vinson syndrome, acquired immunodeficiency syndrome (aids), neurofibromatosis and other diseases with typical cutaneous manifestations.
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Symptoms specific to the upper or lower intestinal tract may direct the initial endoscopic procedure, but data do not support limiting the evaluation to the symptomatic region. 30 mg viagra too much Colonoscopy and upper endoscopy remain the major investigative methods in the evaluation of occult bleeding, although some lesions found on colonoscopy are a chance finding, because not all polyps or cancers have a propensity to bleed.
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The contribution of non-bleeding upper gastrointestinal lesions to occult bleeding cannot be determined with certainty.
In a review of the causes of occult bleeding, ida and fobt are more commonly linked to a bleeding source in the upper gastrointestinal tract (29 to 56 percent) than in the lower gastrointestinal tract (20 to 30 percent).
In addition, the likelihood of finding a bleeding.
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