Last update:
11-Nov-2004

OBJECTIVE To assess the effects of Helicobacter pylori infection and the prior use of non-steroidal antiinflammatory drugs (NSAIDs) on the severity and outcome of upper gastrointestinal bleeding.

METHOD All cases of upper gastrointestinal bleeding due to peptic ulcer or erosive gastroduodenitis admitted to the 3rd Department of Internal Medicine of the Tzanio Ηospital during the period June–December 1997 were identified and subdivided into 2 groups (A and B) using the criterion of blood transfusion. All patients underwent endoscopy and H. pylori infection was diagnosed using serological assay in each of the 2 groups. H. pylori infection and the prior use of NSAIDs were analysed as potential factors for severity of the bleeding.

RESULTS In total 58 patients were identified, 22 in group A (transfused) and 36 in group B (non-transfused). The frequency of H. pylori infection and the use of NSAIDs were similar in the 2 groups (19/22 vs 29/36, P=NS and 13/22 vs 24/36, P=NS, respectively). Patients with multiple endoscopic lesions were not reported to have the potential factors more frequently than those with single lesions. Group A patients more often had lesions related with a high risk of re-bleeding (visible vessel, clot) than group B patients (8/18 vs 3/35 respectively, P=0.0042). However, the patients with such lesions did not have a higher incidence of the studied factors than those without.

CONCLUSIONS H. pylori infection and the use of NSAIDs do not correlate with the severity of the upper gastrointestinal bleeding. The presence of “high-risk” endoscopic lesions is the most important predictive factor for severity.

Key words: Helicobacter pylori, Non-steroidal anti-inflammatory drugs.