IS THE OUTCOME OF UPPER GASTROINTESTINAL- BLEEDING INFLUENCED BY THE ANTISECRETORY DRUG USED

Objective: To investigate whether omeprazole has improved morbidity-mo rtality among patients with upper gastrointestinal bleeding of non-var iceal origin in comparison with ranitidine. Material and methods: Pros pective, randomized and open study, We study 519 consecutive patients admitted to our Service between June 1991 and January 1993 for upper g astrointestinal bleeding of peptic origin, dividing the patients into two randomized groups that were homogeneous in terms of age, sex, prev ious history of gastric disease and upper gastrointestinal bleeding, i ntake of non-steroidal antiinflammatory drugs, and the severity of ble eding on admittance, Thus, Group A consisted of 252 patients treated i mmediately upon arrival at the emergency ward with 50 mg intravenous r anitidine, followed by a further 50 mg every 6 hours. Group B in turn consisted of 267 patients initially given a bolus dose of 80 mg omepra zole intravenously, followed by and additional 40 mg every 8 hours for 48 hours. Forty mg were subsequently administered every 12 hours unti l hospital discharge, Endoscopy was performed in all cases within the first 24 hours following admittance, those patients with active upper gastrointestinal bleeding resulting from Forrest type ulcer of subject ed to endoscopic sclerotherapy were excluded. Results: Duodenal ulcer was the most common cause of bleeding, followed by gastric ulcer and a cute lesions of the mucosa, Emphasis sould be placed on the high incid ence of previous non-steroidal antiinflammatory drug intake in our ser ies (54.5%), We encountered no statistically significant differences b etween the two groups on comparing bleeding stigmata, transfusion requ eriments, recurrences, emergency surgery, the duration of hospital sta y, and mortality. Conclusions: Both drugs were found to possess a simi lar efficacy in treating upper gastrointestinal bleeding of peptic ori gin.