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International consensus

Mid-gastrointestinal bleeding constitutes a small proportion of all cases of gastrointestinal bleeding. It is more difficult to manage mid-gastrointestinal bleeding than upper or lower gastrointestinal bleeding. The etiology differs in younger and older age groups. The clinical presentation, investigations, and management are also different. Capsule endoscopy has improved the diagnostic accuracy to a great extent. Device-assisted enteroscopies (balloon-assisted enteroscopies and spiral enteroscopy) have both diagnostic and therapeutic potentials. Most of the time, patients present with obscure gastrointestinal bleeding which could be overt or occult. Another common presentation is iron deficiency anemia. A stepwise approach is essential to accurately diagnose and manage mid-gastrointestinal bleeding.

**Keywords:** small bowel bleed, occult gastrointestinal bleed, obscure gastrointestinal bleed, capsule endoscopy and gastrointestinal bleed, small bowel angioectasia
