Angiodysplasia epidemiology and demographics: Difference between revisions
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{{Angiodysplasia}} | {{Angiodysplasia}} | ||
{{CMG}} {{AE}} {{ | {{CMG}}; {{AE}} {{NKT}} | ||
==Overview== | ==Overview== | ||
Angiodysplasia is the most common vascular malformation of the GI tract and accounts for 20% of the major episodes of lower intestinal bleeding. The prevalence of angiodysplasia is less than 1% in healthy patients older than 50 years undergoing screening colonoscopy.<ref name="pmid21205256" /> The incidence of angiodysplasia is equal in both men and women. The majority of the affected population is older than 60 years. The most common location of angiodysplasia of the gastrointestinal tract is the colon. | |||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
Angiodysplasia is the most common vascular malformation of the GI tract and accounts for 20% of the major episodes of lower intestinal bleeding. | |||
Angiodysplasia is the most common vascular malformation of the GI tract and accounts for 20% of major episodes of lower intestinal bleeding. | |||
===United States statistics=== | ===United States statistics=== | ||
*The incidence of colonic diverticular and angiodysplasia bleeding per 100,000 person-years increased over time | *The incidence of colonic diverticular and angiodysplasia bleeding per 100,000 person-years increased over time, which may be attributed to an increased frequency of anticoagulant use. | ||
*The prevalence of angiodysplasia is less than 1% in healthy patients older than 50 years undergoing screening colonoscopy.<ref name="pmid21205256">{{cite journal| author=Lanas A, García-Rodríguez LA, Polo-Tomás M, Ponce M, Quintero E, Perez-Aisa MA | display-authors=etal| title=The changing face of hospitalisation due to gastrointestinal bleeding and perforation. | journal=Aliment Pharmacol Ther | year= 2011 | volume= 33 | issue= 5 | pages= 585-91 | pmid=21205256 | doi=10.1111/j.1365-2036.2010.04563.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21205256 }} </ref> | |||
*Angiodysplasia accounts for up to 50% of episodes of recurrent GI bleeding in patients with end-stage renal disease. | *Angiodysplasia accounts for up to 50% of episodes of recurrent GI bleeding in patients with end-stage renal disease. | ||
*The most frequent cause of GI bleeding in patients with von Willebrand disease is angiodysplasia. | *The most frequent cause of GI bleeding in patients with von Willebrand disease is angiodysplasia. | ||
*According to a study, the prevalence of aortic stenosis in patients with endoscopically confirmed angiodysplasia is around 30%.<br /><ref name="pmid8566626">{{cite journal| author=Bhutani MS, Gupta SC, Markert RJ, Barde CJ, Donese R, Gopalswamy N| title=A prospective controlled evaluation of endoscopic detection of angiodysplasia and its association with aortic valve disease. | journal=Gastrointest Endosc | year= 1995 | volume= 42 | issue= 5 | pages= 398-402 | pmid=8566626 | doi=10.1016/s0016-5107(95)70038-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8566626 }} </ref> | |||
<br /> | |||
===International statistics=== | ===International statistics=== | ||
*Extensive studies have not been performed to establish the incidence of angiodysplasia worldwide, but the incidence is in all likelihood similar to that in the United States. | *Extensive studies have not been performed to establish the incidence of angiodysplasia worldwide, but the incidence is in all likelihood similar to that in the United States. | ||
*Predominant location for colonic angiodysplasia in Japanese patients is left colon, whereas it is the right colon for Western patients. Additionally, Japanese patients have a higher incidence of lesions more than 5 mm in size or of elevated type than Western counterparts. | *Predominant location for colonic angiodysplasia in Japanese patients is left colon, whereas it is the right colon for Western patients. Additionally, Japanese patients have a higher incidence of lesions measuring more than 5 mm in size or of elevated type than their Western counterparts.<ref name="pmid17725595">{{cite journal| author=Ueno S, Nakase H, Kasahara K, Uza N, Kitamura H, Inoue S | display-authors=etal| title=Clinical features of Japanese patients with colonic angiodysplasia. | journal=J Gastroenterol Hepatol | year= 2008 | volume= 23 | issue= 8 Pt 2 | pages= e363-6 | pmid=17725595 | doi=10.1111/j.1440-1746.2007.05126.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17725595 }} </ref> | ||
===Race-, sex-, and age-related demographics=== | ===Race-, sex-, and age-related demographics=== | ||
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*Majority of the affected population is older than 60 years. | *Majority of the affected population is older than 60 years. | ||
===Location wise statistics:=== | ===Location wise statistics:=== | ||
===Upper GI tract=== | ===Upper GI tract=== | ||
Angiodysplasia is responsible for non-variceal upper gastrointestinal bleeding in 4–7% of patients. | |||
===Small bowel=== | ===Small bowel=== | ||
In | In patients older than 50 years, the source of obscure gastrointestinal bleeding is most commonly small bowel angiodysplasia. | ||
===Colon=== | ===Colon=== | ||
The | The most common location of angiodysplasia of the gastrointestinal tract is the colon. Within the colon, the cecum and ascending colon are the most frequent location of angiodysplasia in western patients, whereas, descending colon is the most likely site in Japanese patients. | ||
Angiodysplasia of the colon can be accountable for 3% to 40% of the cases of lower GI hemorrhage which can be classified into mild, chronic, recurrent, or life-threatening.<ref name="pmid24138285">{{cite journal| author=Sami SS, Al-Araji SA, Ragunath K| title=Review article: gastrointestinal angiodysplasia - pathogenesis, diagnosis and management. | journal=Aliment Pharmacol Ther | year= 2014 | volume= 39 | issue= 1 | pages= 15-34 | pmid=24138285 | doi=10.1111/apt.12527 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24138285 }} </ref> | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Up to Date]] | |||
[[Category:Gastroenterology]] | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nikita Singh, M.B.B.S.[2]
Overview
Angiodysplasia is the most common vascular malformation of the GI tract and accounts for 20% of the major episodes of lower intestinal bleeding. The prevalence of angiodysplasia is less than 1% in healthy patients older than 50 years undergoing screening colonoscopy.[1] The incidence of angiodysplasia is equal in both men and women. The majority of the affected population is older than 60 years. The most common location of angiodysplasia of the gastrointestinal tract is the colon.
Epidemiology and Demographics
Angiodysplasia is the most common vascular malformation of the GI tract and accounts for 20% of the major episodes of lower intestinal bleeding.
United States statistics
- The incidence of colonic diverticular and angiodysplasia bleeding per 100,000 person-years increased over time, which may be attributed to an increased frequency of anticoagulant use.
- The prevalence of angiodysplasia is less than 1% in healthy patients older than 50 years undergoing screening colonoscopy.[1]
- Angiodysplasia accounts for up to 50% of episodes of recurrent GI bleeding in patients with end-stage renal disease.
- The most frequent cause of GI bleeding in patients with von Willebrand disease is angiodysplasia.
- According to a study, the prevalence of aortic stenosis in patients with endoscopically confirmed angiodysplasia is around 30%.
[2]
International statistics
- Extensive studies have not been performed to establish the incidence of angiodysplasia worldwide, but the incidence is in all likelihood similar to that in the United States.
- Predominant location for colonic angiodysplasia in Japanese patients is left colon, whereas it is the right colon for Western patients. Additionally, Japanese patients have a higher incidence of lesions measuring more than 5 mm in size or of elevated type than their Western counterparts.[3]
- Angiodysplasia affects all races equally.
- The incidence of angiodysplasia is equal in both men and women.
- Majority of the affected population is older than 60 years.
Location wise statistics:
Upper GI tract
Angiodysplasia is responsible for non-variceal upper gastrointestinal bleeding in 4–7% of patients.
Small bowel
In patients older than 50 years, the source of obscure gastrointestinal bleeding is most commonly small bowel angiodysplasia.
Colon
The most common location of angiodysplasia of the gastrointestinal tract is the colon. Within the colon, the cecum and ascending colon are the most frequent location of angiodysplasia in western patients, whereas, descending colon is the most likely site in Japanese patients.
Angiodysplasia of the colon can be accountable for 3% to 40% of the cases of lower GI hemorrhage which can be classified into mild, chronic, recurrent, or life-threatening.[4]
References
- ↑ 1.0 1.1 Lanas A, García-Rodríguez LA, Polo-Tomás M, Ponce M, Quintero E, Perez-Aisa MA; et al. (2011). "The changing face of hospitalisation due to gastrointestinal bleeding and perforation". Aliment Pharmacol Ther. 33 (5): 585–91. doi:10.1111/j.1365-2036.2010.04563.x. PMID 21205256.
- ↑ Bhutani MS, Gupta SC, Markert RJ, Barde CJ, Donese R, Gopalswamy N (1995). "A prospective controlled evaluation of endoscopic detection of angiodysplasia and its association with aortic valve disease". Gastrointest Endosc. 42 (5): 398–402. doi:10.1016/s0016-5107(95)70038-2. PMID 8566626.
- ↑ Ueno S, Nakase H, Kasahara K, Uza N, Kitamura H, Inoue S; et al. (2008). "Clinical features of Japanese patients with colonic angiodysplasia". J Gastroenterol Hepatol. 23 (8 Pt 2): e363–6. doi:10.1111/j.1440-1746.2007.05126.x. PMID 17725595.
- ↑ Sami SS, Al-Araji SA, Ragunath K (2014). "Review article: gastrointestinal angiodysplasia - pathogenesis, diagnosis and management". Aliment Pharmacol Ther. 39 (1): 15–34. doi:10.1111/apt.12527. PMID 24138285.