A Comparison of the Effect of High-dose Oral and Intravenous Proton Pump Inhibitor on the Prevention of Rebleeding after Endoscopic Treatment of Bleeding Peptic Ulcers.
- Author:
Jae Young JANG
1
;
Kwang Ro JOO
;
Young HWANGBO
;
Lae Ik JEONG
;
Sun Young CHOI
;
Ji Heon JUNG
;
Myung Jong CHAE
;
Sang Kil LEE
;
Seok Ho DONG
;
Hyo Jong KIM
;
Byung Ho KIM
;
Young Woon CHANG
;
Joung Il LEE
;
Rin CHANG
Author Information
1. Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea. krjoo@khu.ac.kr
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Peptic ulcer hemorrhage;
Proton pump inhibitor;
Oral;
Intravenous
- MeSH:
Administration, Intravenous;
Hemorrhage*;
Hemostasis;
Humans;
Hydrogen-Ion Concentration;
Mortality;
Peptic Ulcer Hemorrhage;
Peptic Ulcer*;
Proton Pumps*;
Protons*
- From:Korean Journal of Gastrointestinal Endoscopy
2006;33(1):6-11
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The use of proton pump inhibitor (PPI) prevents rebleeding by elevating the intragastric pH in patients with bleeding peptic ulcers after hemostasis has been achieved. We assessed if high-dose oral pantoprazole is as effective as high-dose intravenous pantoprazole for their ability to prevent rebleeding after having achieved initial hemostasis in patients with active bleeding or nonbleeding visible vessels. METHODS: Thirty eight patients with bleeding peptic ulcers who had achieved initial hemostasis were enrolled in this randomized controlled trial. In the high-dose oral pantoprazole group (n=19), 40 mg of pantoprazole was given orally twice daily for 5 days. In the high-dose intravenous pantoprazole group (n=19), an 80 mg intravenous bolus of pantoprazole was given; this was followed by 8 mg/hour of continuous infusion daily for 3 days. Thereafter, 40 mg of pantoprazole was given orally once daily for 8 weeks. RESULTS: The two groups were similar with respect to all the background variables. Rebleeding occurred in 2 patients (10.5%) in the intravenous group and in 1 patient in the oral group (5.3%) by day 30 after enrollment (p=1.000). There was no significant difference in terms of the number of therapeutic endoscopic sessions (1 vs. 1.13+/-0.52), the surgery (0% vs. 0%), the bleeding related mortality (0% vs. 0%), and the mean number of units of transfused blood. CONCLUSIONS: The high-dose oral pantoprazole is as effective as an intravenous administration in reducing rebleeding episodes in patients with bleeding peptic ulcers after successful endoscopic therapy.
