Oral Proton Pump Inhibitors Are as Effective as Endoscopic Treatment for Bleeding Peptic Ulcer : A Prospective, Randomized, Controlled Trial

In managing patients with bleeding peptic ulcers, it has been reported that pharmacologic treatment can be an alternative to endoscopic treatment. We compared the hemostasis rates of the endoscopic treatment, hemoclipping, and the pharmacologic treatment, oral proton pump inhibitors (PPIs), in bleed...

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Bibliographic Details
Published in:Digestive diseases and sciences 2007-12, Vol.52 (12), p.3371-3376
Main Authors: JIN IL KIM, DAE YOUNG CHEUNG, SE HYUN CHO, PARK, Soo-Heon, HAN, Joon-Yeol, JAE KWANG KIM, SOK WON HAN, KYU YONG CHOI, IN SIK CHUNG
Format: Article
Language:English
Subjects:
2-Pyridinylmethylsulfinylbenzimidazoles - administration & dosage
2-Pyridinylmethylsulfinylbenzimidazoles - therapeutic use
Administration, Oral
Adult
Aged
Biological and medical sciences
Duodenal Ulcer
Endoscopy, Gastrointestinal - methods
Enzyme Inhibitors - administration & dosage
Enzyme Inhibitors - therapeutic use
Female
Follow-Up Studies
Gastroenterology. Liver. Pancreas. Abdomen
Hemostasis, Endoscopic - instrumentation
Humans
Male
Medical sciences
Middle Aged
Other diseases. Semiology
Peptic Ulcer Hemorrhage - therapy
Prospective Studies
Proton-Translocating ATPases - antagonists & inhibitors
Rabeprazole
Recurrence
Stomach Ulcer
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Treatment Outcome
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Summary:In managing patients with bleeding peptic ulcers, it has been reported that pharmacologic treatment can be an alternative to endoscopic treatment. We compared the hemostasis rates of the endoscopic treatment, hemoclipping, and the pharmacologic treatment, oral proton pump inhibitors (PPIs), in bleeding peptic ulcer. A randomized prospective study was performed on 129 bleeding peptic ulcer patients with hematemesis or melena. Sixty-two patients were treated by endoscopic hemoclipping and subsequently H(2) receptor antagonists were injected intravenously (hemoclipping group), and 67 patients were treated with an oral PPI without endoscopic treatment (PPI group). The 24-hr gastric pH test was performed sequentially following the treatment. The initial hemostasis rate of the hemoclipping group was 93.5% (58/62) and the rebleeding rate was 6.9% (4/58), and the hemostasis rate of the PPI group was 92.5% (62/67) and the rebleeding rate was 7.5% (5/67), which were not different. The 24-hr gastric pH was 4.54+/-2.56 in the hemoclipping group and 5.97+/-1.30 in the PPI group (P
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-007-9814-4