Title: An Etiological Study of Upper Gastro-intestinal Bleeding with Special Reference to Helicobacter Pylori Infection in Peptic Ulcer Disease
Authors: Dr Ardhendu Kumar Sen, Dr Priyam Goswami, Dr Prasanta Neog, Dr Anupam Dutta, Dr Kalpana Chetia
DOI: http://dx.doi.org/10.18535/jmscr/v4i8.02
OBJECTVE: Upper gastro intestinal bleeding is a common life threatening emergency resulting in a large number of hospital admission. Peptic ulcers are the most common cause of UGIB. Helicobacter pylori plays a pivotal role in the aetiology of peptic ulcer disease and eradication of infection has been known to alter the course of peptic ulcer disease. The present study was undertaken with the aim of studying the aetiological profile of upper gastrointestinal bleeding along with the frequency of helicobacter pylori infection in peptic ulcer disease. MATERIALS AND METHODS: The total of 120 cases admitted between 1st September 2010 to 31st August 2011 and more than 13 years of age, presenting with haematemesis and or malaena were enrolled for the study. They were subjected to upper GI endoscopy after stabilisation. Causes of UGIB was assessed and biopsy material taken in patients with peptic ulcer disease for Rapid Urease test to detect presence of Hpylori. RESULTS: The most common cause of UGIB was found to be peptic ulcer disease (54.16%) , followed by gastroesophageal varies 24.16%, erosive mucosal disease (14.17%), neoplastic lesion (3.33%) malory weiss tear (1.67%) and normal endoscopy was found in 2.5%. Helicobacter pylori infection was found in 56.92% patients with peptic ulcer disease, with higher incidence in duodenal ulcers (62.54%) then in gastric ulcer (48%) CONCLUSION: The present study shows that peptic ulcer disease is the most common cause of UGIB followed by gastro esophageal varices in this part of the country. Helicobacter pylori is commonly associated with peptic ulcer disease. Hence it should be detected and treatment initiated for the effective recovery. Keywords- peptic ulcer, helicobacter pylori. 1. Kankaria AG, Fleischer DE. The critical care management of non-variceal upper gastro-intestinal bleeding. Critical Care Clinics 1995; 347-68. 2. Loren Laine: Helicobacter pylori and Complicated Ulcer Disease. The American Journal of Medicine, July 1996. 3. John Del Valle: Peptic Ulcer Disease and related diseases, Harrisons principles of internal Medicine, 17th, Ed 4. S.Mustafa, N.Ajayi and A.Sheru (2009) : Aetiology of Upper gastrointestinal bleeding in North-Eastern Nigeria: A Retrospective Endoscopic study. The Internet journal of Third World Medicines 2009, Vol-8. 5. A.Timraj et al (2011): Acute Upper Gastrointestinal Bleeding in Morocco : What have changed? ISRN Gastroenterology, Volume 2011, Article ID457946 6. M Uddin et al (2008): Etiology of Upper Gastrointestinal Haemorrhage in a teaching hospital. TAJ 2008; 21(1): 53-57. 7. Kashyap et al: A clinical profile of acute upper gastrointestinal bleeding at moderate altitude : JIACM 2005; 6(3) :224-8. 8. Paik et al : Clinical characteristics of acute upper gastrointestinal bleeding in a tertiary carereferral center. Korean Journal of Gastro-enterology. 2007 Jul;50(1): 26-35. 9. Van Leerdam ME. Epidemiology of acute gastrointestinal bleeding. Best Pract res Gastroenterol, 2008; 22(2): 209-24. 10. C.Sugawa et al (1990). Upper GI bleeding in an urban hospital. Etiology, recurrence and prognosis. Ann Surg. 1990 October 212(4): 521-527. 11. Longstrength GF. Epidemiology of hospital-lizetion for acute upper gastrointestinal haemorrhage- A population based study. Ann J of Gastroenterology.1995 Feb; 90(2) 206-10. 12. Faiza A Qari: Major causes of upper gastrointestinal bleeding at Abdul Aziz University, Jeddah, Kuwait Medical Journal 2001,33(2): 127-130. 13. F.Di Fiore, S.Lecleire, V. Merle et al, “Changes in characteristics and outcome of acute upper gastrointestinal haemorrhage : A comparision of epidemiology and practisee between 1996 and 2000 in a multicentric French study.” European Journal of Gastroenterology and Hepatology, vol 17, no.6 pg 641-647,2005.Abstract
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