Monthly and seasonal variations of acute upper gastrointestinal bleeding in Mosul

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).