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Incidence and etiology of acute non‐malignant upper gastrointestinal bleeding in northern Greece
Author(s) -
Tsesmeli Niki E,
Kotsaftis Panagiotis S,
Savopoulos Christos G,
Hatzitolios Apostolos I,
Kaiafa Georgia D,
Kounanis Andreas D,
Karamitsos Dimitrios T
Publication year - 2007
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2006.04775.x
Subject(s) - medicine , etiology , incidence (geometry) , gastrointestinal bleeding , gastroenterology , optics , physics
Aim: To evaluate the incidence and etiology of acute non‐malignant upper gastrointestinal bleeding (ANMUGIB) in northern Greece due to increased use of non‐steroidal anti‐inflammatory drugs (NSAIDs), including low‐dose aspirin (L‐A), exposure and geographical variability of Helicobacter pylori (Hp) seroprevalence. Methods: A retrospective study of 110 patients admitted for hematemesis or melena during a 6‐month period. All patients had undergone a gastrointestinal (GI) endoscopy during hospitalization. The presence of Hp was identified by biopsies and a 13 C‐urea breath test in the case of Hp(–) biopsy bleeding peptic ulcer (BPU). The activity of ANMUGIB was assessed according to Forrest's classification. Statistical analysis was made by the χ 2 ‐test and Yates' correction. Results: Most patients were in the two medium age groups with no significant difference between them ( P < 0.001). NSAID or L‐A (100 mg/day) use was reported in 42.73% of patients in a ratio 1:1 ( P > 0.1) and Hp infection was found in 29.09% of patients. BPU, with approximately two‐thirds in the bulb, erosions and varices were the most frequent sources. Hp infection was found in 60.65% of BPU, 65.57% were related to NSAIDs or L‐A and 8.19% were non‐Hp non‐NSAID/L‐A BPU. Flat spots were most commonly found with a significant difference ( P < 0.001) to other stigmata of recent bleeding, except for clean base. Conclusions: In northern Greece, persons aged over 40 years are prone to ANMUGIB with a non‐significant relationship to males. Hp infection and medication use, such as NSAIDS and L‐A, are deeply involved in its etiology. Non‐Hp non‐NSAID/L‐A BPU are a small proportion. ANMUGIB seems to have a generally good prognosis.