Endoscopic evaluation of upper gastrointestinal bleeding in high-risk populations for hepatitis B and C: a cross-sectional study.

Abstract

Objective: This cross-sectional study investigates the prevalence and clinical outcomes of upper gastrointestinal bleeding (UGIB) among patients at a tertiary care center. It focuses on esophageal varices and their association with hepatitis C and B infections.

Methods: A total of 383 patients aged 18 and above who presented with UGIB were included. Data were collected from the hospital's endoscopy department and analyzed using Statistical Package for the Social Sciences (SPSS) version 25 and R package. Key variables included age, gender, endoscopic findings, and the presence of esophageal varices. Fisher's exact test was used to evaluate the association between hepatitis infections and variceal bleeding. The statistical significance cut-off was P <0.05.

Results: The mean age of the 383 patients was 56 ± 11 years, with a male predominance (55.4%). Esophageal varices were the most common finding (78.3%) and were strongly associated with hepatitis C (P < 0.001), with 70.7% of hepatitis C patients presenting with varices. Hepatitis B had a much weaker association, with only 1.7% of patients with varices also testing positive for hepatitis B. Acid peptic disease, present in 11% of cases, was more common in females. The statistical analysis confirmed a significant relationship between hepatitis C and esophageal varices. The study highlights the need for routine variceal screening and hepatitis C management in high-risk populations.

Conclusion: Esophageal varices are the leading cause of UGIB in this population, particularly in patients with chronic hepatitis C. The findings underscore the importance of early intervention and management of hepatitis C to reduce the incidence and mortality associated with variceal bleeding in chronic liver disease patients.