The most important factor associated with H. pylori-negative bleeding DU is NSAID use, and if this factor is excluded prevalence of infection is almost 100% (97%), similar to that found in patients with non-bleeding DU (and without NSAID intake). Bleeding DU patients with neither H. pylori infection nor NSAID use are extremely rare (only 2%), which suggests that the pathogenesis of bleeding DU is similar to that of non-complicated DU disease.

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Our case describes an 80-year-old female who presented an asymptomatic lower intestinal bleeding after depositions without hemodynamic repercussion, rectal tenesmus or abdominal pain. She relates alternating constipation and diarrhea in the last twenty years without recent changes. Colonoscopy (done under sedation): Hemorrhoids grade III/IV. Pancolonic diverticulosis. In the cecum mucosa, numerous lineal erosions, 3 to 4 cm long, with inflammatory appearance were found. Ileocecal valve and the fifteen last centimeters of ileum displayed no pathological findings or traces of blood. Biopsies of colonic mucosa did not show any sign of inflammation.