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DOI: 10.1055/s-2003-38146
Acute Upper Gastrointestinal Bleeding: Comparison Between Recent Users and Nonusers of Nonsteroidal Anti-Inflammatory Drugs
Publication History
Submitted 9 February 2002
Accepted after Revision 8 October 2002
Publication Date:
27 March 2003 (online)
![](https://www.thieme-connect.de/media/endoscopy/200304/lookinside/thumbnails/10.1055-s-2003-38146-1.jpg)
Background and Study Aims: To determine clinical, endoscopic, and outcome differences between recent users and nonusers of nonsteroidal anti-inflammatory drugs (NSAIDs) presenting with upper gastrointestinal bleeding (UGIB).
Patients and Methods: A total of 330 consecutive patients who presented with clinical manifestations of UGIB underwent urgent endoscopy after clinical assessment within 12 h of admission. The patients were divided into two groups, depending on whether there was a positive or negative history of recent NSAID use. Urgent endoscopy followed by endoscopic hemostasis and/or biopsy, as needed, was performed by the same endoscopist, who was blinded to the patients’ clinical status.
Results: The baseline characteristics, clinically estimated severity of UGIB, and outcome did not differ between the two groups. Recent NSAID users were found to bleed from an ulcer more frequently (P = 0.009) than nonusers of NSAIDs, the latter more often having a history of peptic ulcer or UGIB (P = 0.02). Bleeding ulcers were mostly duodenal in the NSAID group and gastric in the non-NSAID group (P < 0.001). Helicobacter pylori infection was significantly more common among NSAID users (P < 0.01). The group of NSAID users included a significantly greater proportion of alcohol abusers (P = 0.01), who were found to bleed mostly from erosive gastritis.
Conclusions: Recent NSAID users were found to bleed from ulcers, mostly duodenal, and to have H. pylori infection more frequently than UGI bleeders with a negative history of NSAID consumption. Alcohol abuse was also more common among NSAID users. The severity of bleeding and the outcome did not differ between the two groups.
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A. B. Adamopoulos, M.D.
Third Department of Medicine · University of Athens Medical School · Building Z · Sotiria General Hospital
Mesogion 152 · 11527 Athens · Greece
Fax: +30-1-7719981
Email: gpp@hol.gr