What does this research mean for the field?

The incidence of lower gastrointestinal bleeding (LGIB) has decreased and the mortality rate has significantly declined in Brazil over the last 12 years. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The research aims to assess the causes and mortality rates of patients with gastrointestinal bleeding in Brazil, while analyzing trends over a 12-year period.

March 6, 2026Open Access

Changing Patterns in the Epidemiology of Acutegastrointestinal Bleeding in Brazil Over the Last 12 Years

Key Points

The research aims to assess the causes and mortality rates of patients with gastrointestinal bleeding in Brazil, while analyzing trends over a 12-year period.
Retrospective investigation of patients with gastrointestinal bleeding admitted to a GI Unit from 2012 to 2023.
Classification of gastrointestinal bleeding into non-variceal, variceal, upper, and lower categories.
Analysis of demographics, etiology, and in-hospital mortality rates across two time periods: 2012-2017 and 2018-2023.
2,145 patients admitted, with a decrease in the number during the second period.
Observed etiologies included esophagogastric varices and duodenal ulcers for UGIB, and colonic diverticular disease for LGIB.
Significant shifts in the frequency of LGIB (42.1% vs 38.0%) and mid-GIB (3.8% vs 7.9%) over time were noted.
Increase in mean age and percentage of males among patients, alongside a decrease in mortality from 14.2% to 10.1%.

Abstract

ABSTRACT Background: Gastrointestinal bleeding (GIB) is one of the leading causes of hospitalization attributed to digestive disorders. Little is known about etiology and outcomes of GIB and temporal trends in the incidence of upper GIB (UGIB) and lower GIB (LGIB) in Brazil. Objective: To investigate the main causes and mortality of patients admitted to a tertiary care hospital in Brazil with UGIB and LGIB, as well as to assess trends in epidemiology and outcomes of GIB over time. Methods: All patients admitted to the Gastrointestinal (GI) Unit of the Portuguese Hospital of Salvador, Bahia, Brazil with the diagnosis of GIB between January 2012 and December 2023 were retrospectively investigated. All patients with GIB were classified as non-variceal (NUGIB), variceal (VUGIB) UGIB and LGIB according to standard criteria and managed according to an institutional protocol. Demographics, type and etiology of GIB and in-hospital mortality were evaluated in two different periods, between 2012-2017 (period 1) and 2018-2023 (period 2). Results: 2.145 patients (1.214 males, mean age 70+16 years) were admitted, 1.185 in period 1 and 960 in period 2. Most of the patients had hematochezia and melena. NUGIB, VUGIB, LGIB and mid-GIB were observed in 37.5%, 14.4%, 40.3% and 5.6% of the patients, respectively. The remaining 47 subjects were not investigated due to advanced age or comorbidity. The most common etiologies for UGIB and LGIB were, respectively, esophagogastric varices (EV), duodenal (DU) and gastric ulcer (GU), and colonic diverticular disease (CDD), actinic proctocolitis (APC) and hemorrhoids (HE). Changes in the frequency of LGIB (42.1% vs 38.0% in period 2, P<0.0001) and mid-GIB (3.8% vs 7.9% in period 2, P<0.0001) were recorded over time. Age (68.7+15.6 vs 71+15.7 years in period 2, P=0.001) and gender (54,1% vs 59.1% of males in period 2, P=0.01) were also shown to vary as well as a significant decrease in mortality in recent years (14,2% vs 10.1% of deaths in period 2, P=0.005). Conclusions: EV, DU, GU and CDD, APC and HE were the most frequent causes of UGB and LGIB, respectively. Shifts in demographics, frequency of LGIB and mid-GIB and mortality were demonstrated in recent years.

Changing Patterns in the Epidemiology of Acutegastrointestinal Bleeding in Brazil Over the Last 12 Years

Key Points

Abstract

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