Monthly and seasonal variations of acute upper gastrointestinal bleeding in Mosul

Abstract

Previous studies  have reported seasonal  variations in the incidence  of acute upper gastrointestinal   bleeding  especially  so for peptic  ulcer. There is  no study focusing  on this issue in our locality. The study aimed to assess whether  monthly  and seasonal  climatic changes during the year have an influence on the incidence of bleeding from duodenal  ulcer (DU) and erosive  gastroduodenitis   (EGD);  both of which are major causes  of bleeding  in this region. This  case-series   study  involved  (416) patients  presented   with acute  upper  astrointestinal bleeding at Al-Salam General  Hospital in Mosul during the period from 1 April 2001 to 31 March 2011. All  patients were subjected  to endoscopic  examination   and causes of bleeding,  and date of examination   were documented.  Monthly and seasonal evaluation of bleeding incidents  were made and correlated  with the major causes of bleeding.

The main  causes of bleeding  were  (EGD)  and (DU) making  41.11%  and 30.53%  respectively. Duodenal  ulcer  bleeding  showed  significant  monthly  (p=0.035)  and seasonal  (p=0.005) fluctuations,  peaked  in November,  during autumn,  and the trough was in  July and  August during  summer (P=0.0004).   Bleeding  due to (EGD)  showed  neither  significant  monthly (p=0.117)  nor seasonal  (p=0.711)  variations.  In this  study (DU) bleeding  showed  clear seasonal fluctuation  which  is not detected in bleeding  due to (EGD).