Epidemiology of acute upper gastrointestinal bleeding

Area of Science:

• Gastroenterology
• Epidemiology
• Internal Medicine

Background:

• Acute upper gastrointestinal bleeding (UGIB) presents a critical healthcare challenge.
• Recent epidemiological data on UGIB are scarce, necessitating updated insights.
• Peptic ulcer disease (PUD) admissions and mortality have declined, but PUD bleeding incidence remains stable.

Purpose of the Study:

• To provide current epidemiological data on acute upper gastrointestinal bleeding.
• To identify the primary causes and risk factors for UGIB.
• To assess rebleeding rates and mortality associated with UGIB.

Main Methods:

• Review of recent epidemiological surveys on upper gastrointestinal bleeding.
• Analysis of data on causes, incidence, rebleeding, and mortality.
• Identification of risk factors including NSAID use and H. pylori infection.

Main Results:

• Peptic ulcer bleeding is the leading cause (50%) of UGIB, followed by oesophagitis and erosive disease.
• Rebleeding rates range from 7-16%, particularly high in variceal and peptic ulcer bleeding.
• Mortality is 3-14%, unchanged in a decade, and higher in elderly and comorbid patients.

Conclusions:

• Peptic ulcer bleeding remains a major cause of UGIB with persistent rebleeding and mortality risks.
• NSAID use and H. pylori infection are key risk factors for peptic ulcer bleeding.
• Testing for and eradicating H. pylori in ulcer patients is recommended.