The relationship between upper gastrointestinal hemorrhage and drug use: a case control study

Area of Science:

• Gastroenterology
• Pharmacology
• Epidemiology

Background:

• Upper gastrointestinal hemorrhage is a significant clinical concern.
• Drug use, including over-the-counter medications and traditional remedies, is prevalent.
• Understanding the association between drug consumption and gastrointestinal bleeding is crucial for patient care.

Purpose of the Study:

• To investigate the relationship between the use of various drugs and upper gastrointestinal hemorrhage.
• To identify specific drug classes and lifestyle factors associated with this condition.
• To compare drug usage patterns between patients with upper gastrointestinal hemorrhage and control subjects.

Main Methods:

• A case-control study involving 251 patients admitted with upper gastrointestinal hemorrhage and matched control subjects.
• Data collection focused on the use of non-steroidal anti-inflammatory drugs (NSAIDs), ulcer healing drugs, Chinese proprietary medicines, analgesics, paracetamol, antacids, and other substances.
• Statistical analysis included odds ratios and p-values to determine significant associations.

Main Results:

• NSAID use showed a highly significant association with upper gastrointestinal hemorrhage (odds ratio 14.0, p < 0.00001).
• Other significantly associated drug classes included ulcer healing drugs, Chinese proprietary medicines, analgesics, paracetamol, and antacids.
• Tobacco and alcohol consumption, along with peptic ulcer symptoms, were also significantly higher in cases.

Conclusions:

• NSAID use is a primary factor contributing to upper gastrointestinal hemorrhage, predominantly from peptic ulcers.
• Differences in other drug use may reflect underlying disease patterns, self-medication practices, and polypharmacy.
• The findings underscore the importance of considering medication history in patients presenting with gastrointestinal bleeding.