Epidemiology of upper gastrointestinal bleeding and Helicobacter pylori infection: review of 3,488 Thai patients
Article Category: Brief communication (Original)
Published Online: Jan 31, 2017
Page range: 87 - 93
DOI: https://doi.org/10.5372/1905-7415.0901.373
Keywords
© 2017 Sakolwan Suchartlikitwong, Kamolyut Lapumnuaypol, Rungsun Rerknimitr, Duangporn Werawatganon
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
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bleeding (UGIB) in Thailand is poorly understood and the reported prevalence of Helicobacter pylori infection is outdated.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.