Oral vs Intravenous and Proton Pump Inhibitor (PPI）for Peptic Ulcer Bleeding (PUB)

Launched by CHANGHUA CHRISTIAN HOSPITAL · May 13, 2010

Keywords

ClinConnect Summary

A bleeding peptic ulcer remains a serious medical problem with significant morbidity and mortality. Endoscopic therapy significantly reduces further bleeding, surgery, and mortality in patients with bleeding peptic ulcers (1) and is now recommended as the first hemostatic modality for these patients (1, 2).

In the past few years, adjuvant use of a high-dose proton pump inhibitor (PPI) after endoscopic therapy has been endorsed in some studies, two consensus statements and two meta-analysis (3-8). To sustain a high intragastric pH, a high dose of omeprazole has been used in previous studies...

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Eligibility criteria

• Inclusion Criteria:
• • A peptic ulcer with active bleeding,a non-bleeding visible vessel (NBVV) or an adherent blood clot at the ulcer base is observed within 24 hours of hospital admission
• Exclusion Criteria:
• • Patients are excluded from the study if they are pregnant,
• • Do not obtain initial hemostasis with endoscopic injection of epinephrine
• • Do not give written informed consent
• • Have bleeding tendency (platelet count \<50×109/L,serum prothrombin \<30% of normal,or were taking anticoagulants)
• • Uremia.