Oral versus intravenous proton pump inhibitors in preventing re-bleeding for patients with peptic ulcer bleeding after successful endoscopic therapy

Hsu Heng Yen, Chia Wei Yang, Wei Wen Su, Maw Soan Soon, Shun Sheng Wu, Hwai Jeng Lin

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19 Citations (Scopus)

Abstract

Background: High dose intravenous proton pump inhibitor after endoscopic therapy for peptic ulcer bleeding has been recommended as adjuvant therapy. Whether oral proton pump inhibitor can replace intravenous proton pump inhibitor in this setting is unknown. This study aims to compare the clinical efficacy of oral and intravenous proton pump inhibitor after endoscopic therapy.Methods: Patients with high-risk bleeding peptic ulcers after successful endoscopic therapy were randomly assigned as oral lansoprazole or intravenous esomeprazole group. Primary outcome of the study was re-bleeding rate within 14 days. Secondary outcome included hospital stay, volume of blood transfusion, surgical intervention and mortality within 1 month.Results: From April 2010 to Feb 2011, 100 patients were enrolled in this study. The re-bleeding rates were 4% (2/50) in the intravenous group and 4% (2/50) in the oral group. There was no difference between the two groups with regards to the hospital stay, volume of blood transfusion, surgery or mortality rate. The mean duration of hospital stay was 1.8 days in the oral lansoprazole group and 3.9 days in the intravenous esomeprazole group (p > 0.01).Conclusion: Patients receiving oral proton pump inhibitor have a shorter hospital stay. There is no evidence of a difference in clinical outcomes between oral and intravenous PPI treatment. However, the study was not powered to prove equivalence or non-inferiority. Future studies are still needed.Trial registration: NCT01123031.

Original languageEnglish
Article number66
JournalBMC Gastroenterology
Volume12
DOIs
Publication statusPublished - Jun 8 2012

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Keywords

  • Endoscopic therapy
  • Hemostasis
  • High risk
  • Peptic ulcer
  • Peptic ulcer bleeding
  • Proton pump inhibitor

ASJC Scopus subject areas

  • Gastroenterology

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