Upper gastrointestinal bleeding

Upper gastrointestinal bleeding -classically described as bleeding above the ligament of Treitz

this is bleeding from oesophagus , stomach or duodenum

Lower GI bleeding -less common than UGIB

from small bowel or colon

causes include diverticulosis , angiodysplasia , inflammatory bowel disease , cancer , fissures , piles.

acute medical emergency

substantial cost to healthcare across the globe

UGIB account for 75 % of all GI bleeding presentations

incidence of 90 - 108 / 100,000 inhabitants / year

in UK - AUGBI accounts for 50 - 70,000 admissions / year

reports indicate a fall in incidence of AUGIB ( acute upper GI bl ) in the Western world ( likely due to ↓↓ H.pylori incidence

mortality rates from AUGBI remain high despite advances in management

overall mortality reaches 5 % ( Rotondano et al )

Khoury et al report a mortality rate of 6 % to 10 %

those with peptic ulcer

inflammation of the GI tract

liver cirrhosis , diabetes , chronic renal failure , GORD

polyps or tumours of the GI tract

use of medications as○ aspirin , clopidogrel○ NSAIDs○ steroids○ anticoagulants○ SSRI's

age ( ↑ incidence in elderly but also considerable in younger age group ) ,...