Epidemiology and diagnosis of acute nonvariceal upper gastrointestinal bleeding

Gastroenterol Clin North Am. 2014 Dec;43(4):643-63. doi: 10.1016/j.gtc.2014.08.001. Epub 2014 Sep 12.


Acute upper gastrointestinal bleeding (UGIB) is a common gastroenterological emergency. A vast majority of these bleeds have nonvariceal causes, in particular gastroduodenal peptic ulcers. Nonsteroidal antiinflammatory drugs, low-dose aspirin use, and Helicobacter pylori infection are the main risk factors for UGIB. Current epidemiologic data suggest that patients most affected are older with medical comorbidit. Widespread use of potentially gastroerosive medications underscores the importance of adopting gastroprotective pharamacologic strategies. Endoscopy is the mainstay for diagnosis and treatment of acute UGIB. It should be performed within 24 hours of presentation by skilled operators in adequately equipped settings, using a multidisciplinary team approach.

Keywords: Diagnosis; Endoscopy; Epidemiology; Nonvariceal bleeding; Peptic ulcer; Risk factors; Timing.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Aspirin / administration & dosage
  • Aspirin / adverse effects
  • Duodenal Diseases / diagnosis*
  • Duodenal Diseases / epidemiology
  • Endoscopy, Gastrointestinal*
  • Esophageal Diseases / diagnosis*
  • Esophageal Diseases / epidemiology
  • Gastrointestinal Hemorrhage / diagnosis*
  • Gastrointestinal Hemorrhage / epidemiology*
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / mortality
  • Helicobacter Infections / epidemiology
  • Helicobacter pylori
  • Humans
  • Incidence
  • Platelet Aggregation Inhibitors / adverse effects
  • Risk Factors
  • Stomach Diseases / diagnosis*
  • Stomach Diseases / epidemiology
  • Time Factors


  • Anti-Inflammatory Agents, Non-Steroidal
  • Platelet Aggregation Inhibitors
  • Aspirin