Poor Responders to Intravenous Omeprazole in Patients with Peptic Ulcer Bleeding

Yu Hsi Hsieh, Hwai Jeng Lin, Guan Ying Tseng, Chin Lin Perng, Kun Wang, Wen Ching Lo, Full Young Chang, Shou Dong Lee

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Background/Aims: Although proton pump inhibitors are highly effective in raising intragastric pH, there still remains a small group of patients who resist acid suppression. A high dose of omeprazole has been shown to reduce rebleeding rate in patients with bleeding peptic ulcers after endoscopic therapy. The primary objective of this study was to assess the incidence of peptic ulcer bleeding patients who were resistant to intravenous omeprazole. The secondary objective was to evaluate the relationship between intragastric pH and rebleeding rate in studied patients after successful endoscopic therapy. Methodology: Between Oct. 1996 and Aug. 1999, bleeding peptic ulcer patients who had obtained initial hemostasis with endoscopic therapy were enrolled in this study. In these patients, 40mg of omeprazole was given as intravenous bolus followed by 40mg intravenously every 6 h for 3 days. Thereafter, omeprazole was given 20mg orally once daily for 2 months. The intragastric pH was recorded for hours after the first dose of omeprazole. The occurrence of rebleeding was observed for 14 days. Results: The mean intragastric pH value of these 88 patients was 6.07, (95% CI: 5.91-6.23). Four patients (5%) were found to have omeprazole resistance (pH <4.0, 50% of the time). By the 3rd days after entering the study, more patients with a mean pH <rebled (5/25 vs. 3/63, p <0.05). Conclusions: About five percent of patients with peptic ulcer bleeding respond poorly to intravenous omeprazole. Rebleeding rate is higher in patients with a mean intragastric pH of less than 6.

Original languageEnglish
Pages (from-to)316-319
Number of pages4
JournalHepato-Gastroenterology
Volume51
Issue number55
Publication statusPublished - Jan 2004
Externally publishedYes

Keywords

  • Omeprazole
  • Peptic ulcer
  • pH
  • Poor response
  • Rebleeding

ASJC Scopus subject areas

  • Gastroenterology

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