Current comments on upper gastrointestinal system bleeding data from a research hospital

Abstract

Upper gastrointestinal system (GIS) bleeding is one of the most common causes of hospitalization. This study aims to investigate the etiology of bleeding in patients admitted to Adana Numune Training and Research Hospital with the diagnosis of upper GIS bleeding. The study was conducted with 135 patients who applied for Upper GIS bleeding and underwent endoscopy between April and August 2005. This was a prospective study and all consecutive patients with upper GIS bleeding were included. Data were presented as ‘n, (%)’ ,’ mean ± standard deviation’. Of the patients 65.2% (n=88) were male, and the mean age was 56.7. The most common presenting symptoms were melena 44%(n=60), hematemesis 33% (n=45) and hematemesis+melena 16.3%(n=22). The most common etiologies were duodenal ulcer (35%, n=48), gastric ulcer (17%, n=23) and acute mucosal lesion (11%, n=15). Hp+ cases were 62.2% (n=84). Smoking was 28.1%(n=38), alcohol use was 13.3%(n=18). Of the patients 33% (n=45) had a history of previous Upper (GIS) bleeding, 52% (n=70) had ulcer-dyspepsia and 43% (n=58) had a history of NSAID use. Acetyl salicylic acid (ASA) was most commonly used as NSAID in 68.9%(n=40), flurbibrofen sodium in 39.6%(n=23), diclofenac in 29.3% (n=17) and multiple drugs in 39.6%(n=23). The reasons for taking ASA were cardiovascular protection in 55%(n=22).The use of NSAID’s accompanies upper GİS bleeding with ASA use is the most common. When using these drugs, their effects on upper GI bleeding should be taken into consideration.

Keywords

• Nonsteroidal anti-inflammatory drug
• Acetylsalicylic acid
• Upper gastrointestinal system bleeding
• COVİD-19

References

1. 1. Çimen, O., & Keskin Çimen, F. (2020). Üst Gastrointestinal Sistem Kanamaları: Son 5 Yılda Başvuran 68 Hastanın Retrospektif Analizi. Erzincan University Journal of Science and Technology, 13(1), 364-368. https://doi.org/10.18185/erzifbed.698939
2. 2. Kamboj AK, Hoversten P, Leggett CL. Upper gastrointestinal system (GIS) bleeding: Etiologies and Management. Mayo Clin Proc. 2019 Apr;94(4):697-703. doi:10.1016/j.mayocp.2019.01.022
3. 3. Narum S, Westergren T, Klemp M. Corticosteroids and risk of gastrointestinal bleeding: a systematic review and meta-analysis. BMJ Open. 2014 May 15;4(5): e004587. doi: 10.1136/bmjopen- 2013-004587
4. 4. Ünal M. Üst gastrointestinal sistem kanaması geçiren hastaların etyolojik yönden incelenmesi ve nonsteroid ilaç kullanımının rolü. Yayımlanmamış tıpta uzmanlık tezi. Ankara, 2005. Thesis number: 681969. https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp erişim 1.1.2024
5. 5. Wilkins T, Wheeler B, Carpenter M. Upper gastrointestinal system (GIS) bleeding in Adults: Evaluation and Management. Am Fam Physician. 2020 Mar 1;101(5):294-300. Erratum in: Am Fam Physician. 2021 Jan 15;103(2):70. PMID: 32109037.
6. 6. Tielleman T, Bujanda D, Cryer B. Epidemiology and risk for Upper gastrointestinal system (GIS) bleeding.Gastrointest Endosc Clin N Am.2015;25(3):415-428.
7. 7. Coleman CI, Sobieraj DM, Winkler S, Cutting P, Mediouni M, Alikhanov S, at al. Effect of pharmacological therapies for stroke prevention on major gastrointestinal bleeding in patients with atrial fibrillation. Int J Clin Pract. 2012 Jan;66(1):53-63. doi: 10.1111/j.1742-1241.2011.02809.x. Epub 2011 Oct 31. PMID: 22093613.
8. 8. Trindade AJ, Izard S, Coppa K, et al. Gastrointestinal bleeding in hospitalized COVID‐19 patients: a propensity score‐matched cohort study. Journal of Internal Medicine.2021;289(6), 887– 894. https://doi.org/10.1111/joim.13232

9. 9. Karlafti E, Tsavdaris D, Kotzakioulafi E, Protopapas AA, Kaiafa G, Netta S, et.al. The Prevalence of Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis. Medicina (Kaunas). 2023 Aug 21;59(8):1500. doi: 10.3390/medicina59081500. PMID: 37629790; PMCID: PMC10456782.
10. 10. Çelik B, Karaca B. New regular candidates to the emergency department; lasting symptoms after COVID -19: the example of northwestern Syria: Lasting Symptoms Following COVID -19. İJCMBS [Internet]. 2022 Jul. 6 [cited 2025 Mar. 3];2(2). Available from: https://ijcmbs.com/index.php/ijcmbs/article/view/39
11. 11. Kariyawasam JC, Jayarajah U, Riza R, Abeysuriya V, Seneviratne SL. Gastrointestinal manifestations in COVID-19. Trans R Soc Trop Med Hyg. 2021 Dec 2;115(12):1362-1388. doi: 10.1093/trstmh/trab042. PMID: 33728439; PMCID: PMC7989191.
12. 12. Jin B, Singh R, Ha SE, Zogg H, Park PJ, Ro S. Pathophysiological mechanisms underlying gastrointestinal symptoms in patients with COVID-19. World J. Gastroenterol. 2021, 27, 2341–2352.
13. 13. Ho GCH, Lau WH, Leung MH. Colchicine gastrotoxicity in a patient with chronic kidney disease. Rheumatology (Oxford). 2019 Dec 1;58(12):2229. doi: 10.1093/rheumatology/kez178
14. 14. Recovery Collaborative Group. Tocilizumab in patients admitted to hospital with COVID-19: a randomized, controlled, open-label, platform trial. Lancet. 2021 May 1;397(10285):1637- 1645. doi: 10.1016/S0140-6736(21)00676-0 15. Silaghi A, Gaspar BS, Epistatu D, Bălan DG, Păunică I, Dumitriu AS et al. Upper gastrointestinal system (GIS) bleeding during the COVID-19 pandemic; particularities of diagnosis and therapy. Journal of Mind and Medical Sciences.2022 Vol. 9: Iss. 2, Article 10. DOI: https://doi.org/10.22543/2392-7674.1363. Available at: https://scholar.valpo.edu/jmms/vol9/iss2/10 16. Tavabie OD, Clough JN, Blackwell J, Bashyam M, Martin H, Soubieres A et al. Reduced survival after upper gastrointestinal bleed endoscopy in the COVID-19 era is a secondary effect of the response to the global pandemic: a retrospective cohort study. Frontline Gastroenterol. 2020 Oct 7;12(4):279-287. doi: 10.1136/flgastro-2020-101592. PMID: 34249312; PMCID: PMC8231434.