Acute Upper Gastro-Intestinal Bleeding; Its Etiology and Management in Karbala: An Epidemiological study

Abstract

Acute Upper Gastrointestinal Bleeding is a common medical emergency and potentiallylife threatening condition that needs a prompt assessment and aggressive medical management. To assess the causes, risk factors, and management of acute upper gastrointestinal bleedingin Karbala city; 150 patients (58 females; 92 males) with acute upper gastrointestinal bleedingwere studied during the period of March 2011-March 2012 in Al-Hussein Teaching Hospital. Their age range was (14-89 yr). About 39% of cases were over 60 years old. Peptic ulceration was the commonest cause accounting for 63.3% of cases, followed by acute gastric erosions 18.7%,oesophagealvarices6.7%,and malignant ulcers 4.7%. Non-steroidal anti-inflammatory drug ingestion was the most important risk factor for acute upper gastrointestinal bleedingin addition to smoking and H. pylori infection. Co-morbidity was present in about50% of cases. The use of acid lowering agents such as proton pump inhibitors was the mainstay of therapy for patients with upper gastrointestinal bleeding followed by H2-antagonist. The mortality rate reported in this study was 5.3%. In conclusion, it appears that the most common cause of acute upper gastrointestinal bleedingis acid peptic disease, which increases with the increasing age, frequent consumption of non-steroidal anti-inflammatory drugs, smoking and H. pylori infection. Early diagnosis and prompt treatment are effective in decreasing mortality and morbidity.