Epidemiology of upper gastrointestinal bleeding and Helicobacter pylori infection: review of 3,488 Thai patients

Abstract

Background:The current epidemiology of upper gastrointestinal bleeding (UGIB) in Thailand is poorly understood and the reported prevalence of Helicobacter pylori infection is outdated. Objectives: To investigate the etiologies of UGIB and prevalence of H. pylori infection in Thailand, including its association with UGIB. Methods: We retrieved information regarding patients attending the endoscopic unit of King Chulalongkorn Memorial Hospital from June 2007 to January 2013. A database search using keywords "upper gastrointestinal bleeding" and "iron deficiency" was used. From 4,454 diagnoses, after exclusion criteria, 3,488 patients (2,042 male (58.5%) and 1,446 female (41.5%); mean age 63.3 ± 15.94 years, range 13-103 years) were included. Results: The three most common causes of UGIB were peptic ulcer (38.2%), nonulcer-mucosal lesions (23.4%), and esophageal-related causes (20.4%). The 5 year-incidence of H. pylori was 25%−30%. The overall prevalence was 27%. The prevalence of H. pylori infection was found to decrease with age from 43.8% at <40 years to 21.7% at >79 years old. H. pylori infection was significantly associated with duodenal and gastroduodenal ulcers. Cirrhosis and nonulcer-mucosal lesions were significantly unrelated to H. pylori infection. Patients with concurrent cirrhosis with peptic ulcer were found to be negative for H. pylori infection. Conclusion: Peptic ulcer is the leading cause of UGIB in Thailand. However, its incidence is declining. Patients who presented to hospital with UGIB were older, compared with those a decade ago. H. pylori infection plays an important role in UGIB and its incidence was stable during the past 5 years.

Prevalence of Helicobacter Pylori Infection in Patients with Upper Gastrointestinal Bleeding

“…We compared our results with other studies which show nearly same findings. Dixon MF reported a prevalence rate of H. pylori of 93% for patients with duodenal ulcer and 80% for patients with gastric ulcer [34]. Zhang C et al also found the prevalence rate of H. pylori infection in cases of bleeding gastric ulcer was 80% which is nearly similar to our result [35].…”

Healthcare Disparities and Upper Gastrointestinal Bleeding: Exploring the Linkages

“…Similarly, a study in the United Kingdom found that the cost of UGIB was significantly higher in South Asian patients than in White British patients [ 20 ]. The study attributed this difference to the higher incidence of H. pylori infection in South Asian patients, a significant risk factor for UGIB [ 41 ].…”

Upper gastrointestinal bleeding: Diagnosis of Helicobacter pylori infection—Descriptive study

“…5,6 Peptic ulcer disease as a result of the infection is complicated by gastrointestinal bleeding that can lead to mortality in 0.8%-14% of patients. 7 The diagnosis of H. pylori infection typically relies on noninvasive methods such as the urea breath test and stool antigen testing.…”

“…In developing countries, childhood H. pylori infection usually turns into adulthood chronic infection, and the prevalence of infection increases with the advancement in the age 5,6 . Peptic ulcer disease as a result of the infection is complicated by gastrointestinal bleeding that can lead to mortality in 0.8%–14% of patients 7 …”

“…However, invasive methods like histology, culture, and the rapid urease test (RUT) are also employed for accurate diagnosis 8,9 . Esophago‐gastro‐duodenoscopy is a common procedure used to diagnose gastrointestinal bleeding, where it can indicate the need for tissue biopsy and guide treatment planning 7 . Notably, RUT is conducted using biopsy samples obtained from the stomach lining, specifically the antrum and corpus.…”