Endoscopy 2003; 35(4): 327-332
DOI: 10.1055/s-2003-38146
Original Article
© Georg Thieme Verlag Stuttgart · New York

Acute Upper Gastrointestinal Bleeding: Comparison Between Recent Users and Nonusers of Nonsteroidal Anti-Inflammatory Drugs

A.  Adamopoulos1 , S.  Efstathiou1 , D.  Tsioulos1 , A.  Tsami1 , A.  Mitromaras1 , T.  Mountokalakis1
  • 1Third University Dept. of Internal Medicine, Sotiria General Hospital, Athens, Greece
Weitere Informationen

Publikationsverlauf

Submitted 9 February 2002

Accepted after Revision 8 October 2002

Publikationsdatum:
27. März 2003 (online)

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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.

References

A. B. Adamopoulos, M.D.

Third Department of Medicine · University of Athens Medical School · Building Z · Sotiria General Hospital

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