What do the terms upper GI bleeding (UGIB), lower GI bleeding (LGIB), and middle GI bleeding (MGIB) mean?
Although this categorization is appealingly simplistic, sometimes clinically suspected MGIB, based on one negative EGD and one negative colonoscopy, turns out to be UGIB that was missed on an initial EGD or LGIB that was missed on an initial colonoscopy. This initial misdiagnosis can occur in up to 20% of cases of suspected MGIB.
Categorization of Gastrointestinal Bleeding Terms
|Location||Definition||Method of Evaluation|
|UGIB||Esophagus, stomach, duodenum to the ligament of Treitz||EGD|
|LGIB||Colon from the ileocecal valve to the anus||Colonoscopy (usually)|
Nuclear medicine studies or arteriography (special situations)
|MGIB||Small bowel from ligament of Treitz to the ileocecal valve||Capsule endoscopy, enteroscopy (push-type, single balloon, or double balloon)|
Radiologic (contrast enterography)
EGD, Esophagogastroduodenoscopy; LGIB, lower gastrointestinal bleeding; MGIB, middle gastrointestinal bleeding; UGIB, upper gastrointestinal bleeding.