Aetiology and other features of a cohort of adult Sri Lankans presenting with upper gastrointestinal bleeding (UGIB)

Abstract

Results: There were 342 (24%) upper GI bleeders. The mean age of presentation was 55.5 years +/-14.4 SD. A high proportion was seen between 50-70 years of age. Sex distribution was, male:female = 229:114 (2:1). 45% have presented with haematemesis, 31% with malaena, and 24% with both. Endoscopy showed the presence of severe antral gastritis and duodenitis, oesophageal varices, oesaphagitis, erosive gastropathy, portal hypertensive gastropathy, pangastritis and peptic ulcer disease in 38%, 35%, 28%, 28%, 20%, 17% and 15% of the instances respectively. Hiatus herniae were seen in 43% although its role was unclear. Often combined pathologies were seen. Only 52% of the varices showed endoscopic evidence of bleeding. Excess alcohol consumption was seen in 36% while 5% were on NSAIDs. 5% had endoscopic negatives.Conclusions: UGIB is a major problem to the endoscopist, constituting about 25% of the work load, in this part of the continent. Although approximately 50% of the varices found had bled, portal hypertension related pathologies are a cause for concern. Alcohol was a contributory factor in 1/3 of the endoscoped population. Bleeding from PUD was not a dominant feature compared to the west.

Findings of Esophagogastroduodenoscopy in Patients Suspected of Upper Gastrointestinal Bleeding Referred to the Main Endoscopy Unit at King Fahad Specialist Hospital

“…In this study, the median age of the studied patients was 45 years, and males outnumbered females (approximately 2:1 ratio). This finding coincides with several reports obtained from a prospective study on patients with UGIB in Iceland [9], a multicenter study in USA [8], a cohort of adult Sri Lankans [10], and a tertiary care center in Nepal [11].…”

“…However, duodenal and gastric ulcers accounted for 43% of patients with UGIB in Nepal, followed by variceal bleeding in 23% of cases [ 11 ]. Another study in Sri Lanka identified severe erosive antral gastritis and duodenitis as the most frequent causes of UGIB, while chronic duodenal and gastric ulcers were less frequent [ 10 ]. The predominance of non-variceal causes has also been stated in several studies from different geographical areas [ 13 , 14 ].…”

Study of Endoscopic Findings in First Episode of Upper Gastrointestinal Bleeding

“…5 Another study in Sri Lanka identified severe erosive antral gastritis and duodenitis as the most frequent causes of UGIB, while chronic duodenal and gastric ulcers were less frequent. 19 Peptic ulcer disease 35% followed by oesophageal/gastric Varices 20% was most common endoscopic findings in another similar studies. 20…”

Risk factors leading to peptic ulcer disease: systematic review in literature

“…61 Satarasinghe and colleagues in a series of 1500 patients found alcohol was a contributory factor in one third of gastrointestinal bleeding (IGIB) patients. 63…”