IS MEDICATION WITH PROTON PUMP INHIBITORS MORE EFFECTIVE THAN H-2-RECEPTOR ANTAGONISTS AFTER ENDOSCOPIC HEMOSTASIS OF ULCER BLEEDING

During a two year period (1999-1993) we investigated whether or not, a fter endoscopic therapy of bleeding ulcers, the suppression of gastric acid secretion with an administration of a proton pump blocker (Omepr azol(R)) is more effective than the administration of H-2-receptor ant agonist (Ranitidin(R)) with respect to prevention of recurrent bleedin g episodes, frequency of surgical intervention and mortality. 106 pati ents (64 men, 42 women) were treated with the proton pump blocker and 126 patients (82 men, 44 women) received the H-2-receptor antagonist. Patients were treated either with an initial dose of 80 mg Omeprazol f ollowed by 3 x 40 mg Omeprazol i.v. or with a daily dose of 3 mg/kg bo dy weight Ranitidin i.v. No significant differences could be detected between the two treatment regimes with respect to the parameters menti oned above. Rebleeding which could be controlled by endoscopic hemosta sis occurred in 19.8% vs. 17.5% (Omeprazol/Ranitidin) of patients. Sur gical intervention because of rebleeding was necessary on 8.5% vs. 8.7 % of the patients. Mortality due to hemorrhage was 5.7% vs. 4.0%. From these results we conclude that, following endoscopic hemostasis of bl eeding ulcers, Omeprazol has no advantage over Ranitidin using our dos age regimes.