The effect of endoscopic therapy in patients receiving omeprazole for bleeding ulcers with nonbleeding visible vessels or adherent clots: a randomized comparison

Article Abstract:

Background: The optimal treatment of ulcers with nonbleeding visible vessels and adherent clots is unclear. Objective: To compare intravenous omeprazole infusion plus endoscopic therapy with intravenous omeprazole infusion alone for prevention of recurrent bleeding from ulcers with nonbleeding visible vessels or adherent clots. Design: Single-blind randomized study with blinded evaluation of study end points. Setting: An endoscopy center in a university hospital in Hong Kong. Patients: 156 persons with upper gastrointestinal bleeding and ulcers showing nonbleeding visible vessels or adherent clots. Intervention: Combination of endoscopic therapy and omeprazole infusion versus sham endoscopic therapy and omeprazole infusion. Measurements: Recurrent ulcer bleeding before discharge and within 30 days. Results: 78 patients were recruited in each group. Ulcer bleeding recurred before discharge in seven patients who received intravenous omeprazole alone (9%) and no patients who received combined therapy (difference, 9 percentage points [95% CI, 1.7 to 17.6 percentage points]; P=0.01). The probability of recurrent bleeding within 30 days was 11.6% (9 patients) in the omeprazole-alone group and 1.1% (1 patient) in the combined therapy group (difference, 10.5 percentage points [CI, 1.7 to 19.8 percentage points]; P=0.009). Patients in the combined therapy group required less transfusion (difference in median units of blood transfused, 1 unit [CI, 0 to 2 units]; P=0.02). One patient in the combined therapy group had surgery for ulcer perforation. Four patients receiving omeprazole alone (5.1%) and two patients receiving combined therapy (2.6%) died within 30 days. Conclusion: The combination of endoscopic therapy and omeprazole infusion is superior to omeprazole infusion alone for preventing recurrent bleeding from ulcers with nonbleeding visible vessels and adherent clots.

Omeprazole, Author Abstract

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Endoscopic retreatment compared with surgery in patients with recurrent bleeding after initial endoscopic control of bleeding ulcers

Article Abstract:

Endoscopic treatment appears to be more cost-effective than surgery for patients with recurring peptic ulcer bleeding. During endoscopic treatment, a flexible tube with an electrode at the end is inserted into the stomach. The electrode heats the ulcer and stops the bleeding. Researchers randomly assigned 92 patients with recurring bleeding following endoscopy to receive additional endoscopy or surgery. Those treated with endoscopy had fewer complications and lower death rates than those treated surgically.

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Omerpazole before endoscopy in patients with gastrointestinal bleeding

Article Abstract:

The influence of preemptive infusion of omerpazole on the need for endoscopic treatment before endoscopy is studied as a neutral gastric pH is essential for the stability of clots over bleeding arteries. It was observed that the high-dose of omerpazole before endoscopy increased the treatment of symptoms of bleedings in ulcers and minimized the requirement of endoscopic treatment.

Science & research, In-Vitro Diagnostic Substance Manufacturing, Diagnostic substances, Diagnostic Chemicals, Diagnostic Reagents, Research, Usage, Diagnosis, Endoscopy, Clinical report

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