Melena epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Tayyaba Ali, M.D.[2]


Epidemiology and Demographics


  • The annual incidence of hospitalization for acute upper gastrointestinal bleeding (UGIB) in the United States is approximately 65 per 100,000 individuals.[1]


  • The prevalence of melena is almost the same as incidence, as it is a manifestation of an acute condition and is not a chronic disease.

Case-fatality rate/Mortality rate

  • Overall mortality decreased from 17.1 to 8.2 per 100,000/y which corresponded to a 60.8% decrease after adjustment for age (95% CI, 46.5%-75.1%). The age-standardized mortality rate for ulcer bleeding decreased by 56.5% (95% CI, 41.9%-71.1%).[2]


  • The incidence of upper gastrointestinal bleed increases with age and decreases in people younger than 70 years of age.[2]


  • According to one study done in 2196 patients with upper gastrointestinal bleeding. 620 (28%) were black, 625 (29%) white, 881 (40%) Hispanic, and 70 (3%) were members of other ethnicities.
  • In all ethnicities, gastrointestinal ulcer disease is the most common cause of bleeding or melena in patients younger than 35 or older than 65 years. Certain differences in terms of etiology of melena were observed among patients aged 35 to 64 years.
  • Blacks aged 50 to 64 years frequently experienced gastroduodenal ulcers, whereas Hispanics aged 35 to 49 years typically had esophageal varices. Rebleeding rates were significantly lower in whites (5.8%) than in Hispanics (9.9%) or blacks (8.7%) (P=0.02).[3]


  • The incidence of UGIB is higher in males than in females (128 versus 65 per 100,000 in one study).[4]


  1. Wuerth BA, Rockey DC (2018). "Changing Epidemiology of Upper Gastrointestinal Hemorrhage in the Last Decade: A Nationwide Analysis". Dig Dis Sci. 63 (5): 1286–1293. doi:10.1007/s10620-017-4882-6. PMID 29282637.
  2. 2.0 2.1 Loperfido S, Baldo V, Piovesana E, Bellina L, Rossi K, Groppo M; et al. (2009). "Changing trends in acute upper-GI bleeding: a population-based study". Gastrointest Endosc. 70 (2): 212–24. doi:10.1016/j.gie.2008.10.051. PMID 19409558.
  3. Wollenman CS, Chason R, Reisch JS, Rockey DC (2014). "Impact of ethnicity in upper gastrointestinal hemorrhage". J Clin Gastroenterol. 48 (4): 343–50. doi:10.1097/MCG.0000000000000025. PMC 4157370. PMID 24275716.
  4. Enestvedt BK, Gralnek IM, Mattek N, Lieberman DA, Eisen G (2008). "An evaluation of endoscopic indications and findings related to nonvariceal upper-GI hemorrhage in a large multicenter consortium". Gastrointest Endosc. 67 (3): 422–9. doi:10.1016/j.gie.2007.09.024. PMID 18206878.

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