Browse Guides  internal medicine  gastroenterology

Upper gastrointestinal bleed

Prevalence
Causes
Clinical features
Investigations
Therapy
Prevention
Prognosis
Prevalence

Upper gastrointestinal bleeding is relatively common in
  • patients on NSAIDs a
  • patients on intensive care units b
  • elderly patients b
Note:
  • Around one in a thousand patients recently started on NSAIDs have a GI haemorrhage or perforation (0.11%: 95% CI: 0.094% to 0.13%) a
  • One in twelve patients on intensive care units for longer than 2 days have an upper GI bleed (8.7%: 95% CI: 6.8% to 11%) b

Old age increases the risk for a bleeding peptic ulcer

Patient Prognostic Factor Outcome CER OR
(95% CI)
NNF+
(95% CI)
well b aged >75
independent
bleeding peptic ulcer
at 19 months
0.13% 5.1
(3.3 to 7.8)
190
(110 to 330)

  • A suspected upper GI bleed is proved correct in a third of in-patients (39%: 95% CI: 27% to 51%) c

Expiry date: July 2003
Levels of Evidence used in grading these guides

Author   A   Townsend , CM   Ball
Reviewer   L   Friedman
CAT Writers   A   Townsend , CM   Ball , CJ   Wotton