Nonvariceal upper gastrointestinal bleeding

Park, Tina; Wassef, Wahid

doi:10.1097/mog.0000000000000123

Cited by 11 publications

(6 citation statements)

References 21 publications

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“…H. pylori infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) are independent risk factors for PUB ( 13 ). Eradication of H. pylori can significantly reduce the risk of recurrent peptic ulcer and its complications ( 14 ). Further studies are required to determine whether H. pylori infection is one of the pathogenic factors for PUB in extreme climates.…”

Section: Discussionmentioning

confidence: 99%

Seasonal changes in gastric mucosal factors associated with peptic ulcer bleeding

Yuan

Xie

Jiang

et al. 2014

Experimental and Therapeutic Medicine

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A close association has been established between climate and peptic ulcer bleeding (PUB). The incidence of PUB in cold climates is significantly higher than that in hot climates. In this study, gastric mucosal damage and its barrier function (through associated barrier factors) in extreme climate conditions were examined to investigate the pathogenesis of PUB in extreme cold climates. Gastric juice and biopsy specimens were collected from 176 patients with peptic ulcer. Conventional hematoxylin and eosin staining was used to exclude malignant ulcers. Helicobacter pylori infections were detected by modified Giemsa staining. pH values of the gastric juice samples were obtained on-site by precise pH dipstick readings. The protein expression levels of heat shock protein (HSP) 70, occludin, nitric oxide synthase (NOS), epidermal growth factor (EGF) and EGF receptor (EGFR) in the gastric mucosa were detected by immunohistochemistry. No significant differences were identified between the high and low bleeding risk groups in the rates of H. pylori infection and the pH values of the gastric juices in the extreme hot or cold climates. Furthermore, no statistically significant differences were identified in the protein expression levels of occludin, NOS, EGF and EGFR between the high and low bleeding risk groups. In the extreme cold climate, the expression of HSP70 and the mucus thickness of the gastric antrum in the high bleeding risk group were significantly lower than those in the low bleeding risk group. The protein expression levels of occludin, HSP70, NOS and EGFR in the extreme cold climate were significantly lower than those in the extreme hot climate, whereas the gastric acid secretion was significantly higher in the extreme cold climate than that in the extreme hot climate. In conclusion, low expression of HSP70 in the gastric mucosa and reduced gastric mucus thickness may play key roles in the mechanism of PUB in extreme cold climates. The significant decrease in barrier factors and increase in damage in extreme cold climates may be associated with the seasonal pattern of peptic ulcers.

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Section: Discussionmentioning

confidence: 99%

Seasonal changes in gastric mucosal factors associated with peptic ulcer bleeding

Yuan

Xie

Jiang

et al. 2014

Experimental and Therapeutic Medicine

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“…All patients were treated with comprehensive routine therapy according to the guidelines for diagnosis and treatment of NVUGIB. [ 9 – 11 ]…”

Section: Methodsmentioning

confidence: 99%

Simple risk factors to predict urgent endoscopy in nonvariceal upper gastrointestinal bleeding pre-endoscopically

Wang

Tang

et al. 2016

Medicine

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The goal of this study is to evaluate how to predict high-risk nonvariceal upper gastrointestinal bleeding (NVUGIB) pre-endoscopically. A total of 569 NVUGIB patients between Match 2011 and January 2015 were retrospectively studied. The clinical characteristics and laboratory data were statistically analyzed. The severity of NVUGIB was based on high-risk NVUGIB (Forrest I–IIb), and low-risk NVUGIB (Forrest IIc and III). By logistic regression and receiver-operating characteristic curve, simple risk score systems were derived which predicted patients’ risks of potentially needing endoscopic intervention to control bleeding. Risk score systems combined of patients’ serum hemoglobin (Hb) ≤75 g/L, red hematemesis, red stool, shock, and blood urine nitrogen ≥8.5 mmol/L within 24 hours after admission were derived. As for each one of these clinical signs, the relatively high specificity was 97.9% for shock, 96.4% for red stool, 85.5% for red hematemesis, 76.7% for Hb ≤75 g/L, and the sensitivity was 50.8% for red hematemesis, 47.5% for Hb ≤75 g/L, 14.2% for red stool, and 10.9% for shock. When these 5 clinical signs were presented as a risk score system, the highest area of receiver-operating characteristic curve was 0.746, with sensitivity 0.675 and specificity 0.733, which discriminated well with high-risk NVUGIB. These simple risk factors identified patients with high-risk NVUGIB of needing treatment to manage their bleeding pre-endoscopically. Further validation in the clinic was required.

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“…Nonvarices upper gastrointestinal bleeding (NUGIB) is one of the most common encountered emergency disorders in daily clinical practice worldwide. [1][2][3][4][5] It is reported that its incidence varies between 50 and 150 cases per 100,000 adults annually. [6][7][8][9] Although its therapeutic managements have developed, its morbidity and mortality rate remain substantial.…”

Section: Introductionmentioning

confidence: 99%

Study on the preventive effect of intravenous esomeprazole in the management of nonvarices upper gastrointestinal bleeding

Sun¹,

Yuan²,

Ma³

et al. 2021

Medicine

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This retrospective study investigated the preventive effect of intravenous esomeprazole (IVEO) in the prevention of nonvarices upper gastrointestinal bleeding (NUGIB). This study enrolled 130 patients with NUGIB and all of them underwent successful endoscopic hemostasis, of which 65 cases received routine management and IVEO (Group A) and the other 65 cases received routine management alone (Group B). The primary outcome (recurrent bleeding rate within 72-hour, 7-day, and 30-day), and secondary outcomes ((all-cause mortality, bleeding-related mortality, blood transfused, hospital stay (day), and incidence of adverse events)) were compared between 2 groups. Patients in the group A showed lower recurrent bleeding rate within 72-hour( P < .05), 7-day ( P < .05), and 30-day ( P < .05), than that of patients in the group B. However, no significant differences were identified in all-cause mortality( P = .26), bleeding-related mortality ( P = .57), blood transfused ( P = .33), and hospital stay ( P = .74) between 2 groups. In addition, both groups had similar safety profile. This study found that routine management and IVEO was superior to the routine management alone for preventing the recurrent bleeding rate after successful endoscopic hemostasis in patients with NUGIB.

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Nonvariceal upper gastrointestinal bleeding

Abstract: Upper gastrointestinal bleeding from peptic ulcer disease is not a new clinical problem. Yet, the approach to management continues to evolve with the accumulation of data and well designed studies on the subject.

Cited by 11 publications

References 21 publications

Seasonal changes in gastric mucosal factors associated with peptic ulcer bleeding

Seasonal changes in gastric mucosal factors associated with peptic ulcer bleeding

Simple risk factors to predict urgent endoscopy in nonvariceal upper gastrointestinal bleeding pre-endoscopically

Study on the preventive effect of intravenous esomeprazole in the management of nonvarices upper gastrointestinal bleeding

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