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Best Pract Res Clin Gastroenterol. 2019 Oct - Dec;42:101610. doi: 10.1016/j.bpg.2019.04.003. Epub 2019 Apr 17.

Changing epidemiology and etiology of upper and lower gastrointestinal bleeding.

Best practice & research. Clinical gastroenterology

Kathryn Oakland

Affiliations

  1. Digestive Diseases and Renal Department, HCA Healthcare UK, 242 Marylebone Road, London, NW16JL, United Kingdom. Electronic address: [email protected].

PMID: 31785737 DOI: 10.1016/j.bpg.2019.04.003

Abstract

Upper gastrointestinal bleeding (UGIB) develops in the oesophagus, stomach or duodenum and has an incidence of 47/100,000. Lower GIB (LGIB) develops in the small bowel, colon or anorectum and has an incidence of 33/100,000. Where the incidence of UGIB has fallen, driven by helicobacter pylori eradication and the use of proton pump inhibitors, the incidence of LGIB may be increasing. Interventions such as early endoscopy, risk assessment and national guidelines have improved clinical outcomes but have had limited impact on the economic burden of GIB. Previously LGIB was thought to be less severe than UGIB, but contemporary data suggest that patients with LGIB tend to have a longer length of hospital stay and may be at higher risk of death or re-bleeding.

Copyright © 2019 Elsevier Ltd. All rights reserved.

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