{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T03:49:02Z","timestamp":1783482542429,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,5,24]],"date-time":"2015-05-24T00:00:00Z","timestamp":1432425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2015,8]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>While efforts have focused on the prevention of overt upper gastrointestinal bleeding (UGIB<\/jats:styled-content>), little is known about occult GIB<\/jats:styled-content>, which might also originate from sites not protected by acid inhibition.<\/jats:p><\/jats:sec>Aim<\/jats:title>To measure the incidence and outcomes of both overt and occult GIB<\/jats:styled-content> over a 6\u2010year period (2007\u20132012), and to assess the use of NSAID<\/jats:styled-content>s, anti\u2010thrombotic therapy (ATT<\/jats:styled-content>), proton pump inhibitors (PPI<\/jats:styled-content>s), and iron therapy.<\/jats:p><\/jats:sec>Methods<\/jats:title>A sample of 300 patients (100 from each of three index years) with occult GIB<\/jats:styled-content> was randomly selected and their outcomes were compared with those of patients with overt UGIB<\/jats:styled-content> (N<\/jats:italic>\u00a0=\u00a0869).<\/jats:p><\/jats:sec>Results<\/jats:title>The incidence of overt UGIB<\/jats:styled-content> fell from 140.1 per 100\u00a0000 population per annum in 2007 to 106.8 in 2010 and to 88.0 in 2012 (P<\/jats:italic>\u00a0<\u00a00.001); while that of occult GIB<\/jats:styled-content> rose from 243.1 to 263.6 and to 292.8 (P<\/jats:italic>\u00a0<\u00a00.001) over the same period. The incidence of occult GIB<\/jats:styled-content> was highly correlated with the number of prescriptions of PPI<\/jats:styled-content>s per 1000 population (\u03c72<\/jats:sup> trend\u00a0=\u00a011.80; P<\/jats:italic>\u00a0<\u00a00.001). In the overt UGIB<\/jats:styled-content> group, the median haemoglobin level on presentation was lowest (10.3) in patients taking NSAID<\/jats:styled-content>s\/ATT<\/jats:styled-content> plus PPI<\/jats:styled-content>s compared with those taking PPI<\/jats:styled-content>s alone (11.5), NSAID<\/jats:styled-content>s\/ATT<\/jats:styled-content> alone (10.4) or none of these drugs (12.7\u00a0g\/dL) (P<\/jats:italic>\u00a0<\u00a00.001, Kruskal\u2013Wallis).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>An inverse trend seems to have formed in the incidence of overt vs. occult gastrointestinal bleeding<\/jats:styled-content> in association with the wider use of PPI<\/jats:styled-content>s and NSAID<\/jats:styled-content>s. An alternative approach to acid inhibition is needed to prevent gastrointestinal bleeding<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13265","type":"journal-article","created":{"date-parts":[[2015,5,25]],"date-time":"2015-05-25T13:52:31Z","timestamp":1432561951000},"page":"375-382","source":"Crossref","is-referenced-by-count":9,"title":["Occult vs. overt upper gastrointestinal bleeding \u2013 inverse relationship and the use of mucosal damaging and protective drugs"],"prefix":"10.1111","volume":"42","author":[{"given":"A. S.","family":"Taha","sequence":"first","affiliation":[{"name":"Gastroenterology University Hospital Crosshouse Kilmarnock UK"},{"name":"Kilmarnock and the School of Medicine University of Glasgow Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"McCloskey","sequence":"additional","affiliation":[{"name":"Gastroenterology University Hospital Crosshouse Kilmarnock UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Craigen","sequence":"additional","affiliation":[{"name":"Gastroenterology University Hospital Crosshouse Kilmarnock UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Simpson","sequence":"additional","affiliation":[{"name":"Gastroenterology University Hospital Crosshouse Kilmarnock UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. J.","family":"Angerson","sequence":"additional","affiliation":[{"name":"Kilmarnock and the School of Medicine University of Glasgow Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,5,24]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"206","article-title":"Epidemiology of hospitalization for acute upper gastrointestinal hemorrhage: a population\u2010based study","volume":"90","author":"Longstreth GF","year":"1995","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.164"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.01.043"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60596-6"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2006.04.010"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.228437"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2012-100280"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2014-100453"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.08.032"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.06.039"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2003.50054"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.07.067"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2012-301632"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-011-1589-y"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.108613"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.06.007"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2013-132231"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.228874"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.06.075"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00619-6"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.03.020"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2007.04.031"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60673-3"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199209103271101"}],"container-title":["Alimentary Pharmacology & Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.13265","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.13265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T22:56:12Z","timestamp":1695509772000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.13265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,5,24]]},"references-count":24,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015,8]]}},"alternative-id":["10.1111\/apt.13265"],"URL":"https:\/\/doi.org\/10.1111\/apt.13265","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,5,24]]}}}