Changing epidemiology and etiology of upper and lower gastrointestinal bleeding

• Published in: Baillière's best practice & research. Clinical gastroenterology Vol. 42-43; p. 101610
• Main Author: Oakland, Kathryn
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.10.2019; Elsevier Limited
• Subjects: Age; Anticoagulants; Audits; Clinical outcomes; Endoscopy; Epidemiology; Gastrointestinal Hemorrhage - epidemiology; Gastrointestinal Hemorrhage - etiology; Health care access; Health risk assessment; Humans; Incidence; Infections; Morbidity; Patients; Risk Assessment; Studies; Trends; Ulcers; United States > US; Spain
• ISSN: 1521-6918; 1532-1916; 1532-1916
• DOI: 10.1016/j.bpg.2019.04.003

Upper gastrointestinal bleeding (UGIB) develops in the oesophagus, stomach or duodenum and has an incidence of 47/100,000. Lower GIB (LGIB) develops in the small bowel, colon or anorectum and has an incidence of 33/100,000. Where the incidence of UGIB has fallen, driven by helicobacter pylori eradication and the use of proton pump inhibitors, the incidence of LGIB may be increasing. Interventions such as early endoscopy, risk assessment and national guidelines have improved clinical outcomes but have had limited impact on the economic burden of GIB. Previously LGIB was thought to be less severe than UGIB, but contemporary data suggest that patients with LGIB tend to have a longer length of hospital stay and may be at higher risk of death or re-bleeding.