McMaster Textbook of Internal Medicine

McMaster Textbook of Internal Medicine
Interviews
Gastroenterology
Common causes of GI bleeding nowadays

Common causes of GI bleeding nowadays

2018-07-02

Janusz Jankowski

What is the most common cause of gastrointestinal bleeding nowadays? Has the etiology of gastrointestinal bleeding changed over the past decades?

Janusz Jankowski: The answer to the first question is, it is still gastric ulceration and duodenal ulceration, peptic ulceration, if you will. The second commonest cause are gastric erosions, superficial ulcers, if you like. And the third cause are esophageal varices and gastric varices.

The frequency of these is changing slightly. Gastric and peptic ulcerations are becoming slightly less frequent simply because of the eradication of Helicobacter pylori. However, gastric erosions are increasing because of the amount of anticoagulation being used, low-dose aspirin, etc. However, the big risk that we have to consider in the future is the increase of esophageal and gastric varices because of the increase of alcoholic hepatitis and cirrhosis and, indeed, hepatitis C.

See also

Noninvasive techniques for evaluating liver fibrosis and cirrhosis Are there any validated noninvasive diagnostic techniques that may be used for evaluation of liver fibrosis and cirrhosis?
Compliance with H pylori eradication regimens Is compliance a problem in patients receiving the recommended Helicobacter pylori eradication regimens?
Desirable bacterial strains in FMT What bacterial strains should be present in fecal material used for fecal microbiota transplantation (FMT)? Do you select a donor on the basis of the bacterial strains present in the fecal material?
NOACs and the rate of GI bleeding worldwide It has already been several years since the wide adoption of new oral anticoagulants, such as dabigatran or rivaroxaban. Are we able to estimate how it has influenced the rate of gastrointestinal bleeding (GI) worldwide?
Current management of acute nonvariceal GI bleeding A lecture by Dr Janusz Jankowski, from University of Central Lancashire, UK, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2017.
Role of 24-hour pH-metry in GERD What is the role of 24-hour pH-metry in patients with atypical gastroesophageal reflux disease (GERD) and in those with classic GERD? At what stage of diagnostic workup should pH-metry be performed?
Changing approaches to inflammatory bowel disease management A lecture by Prof. John Marshall, from McMaster University, Canada, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2016.

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