ORALLY-ADMINISTERED OMEPRAZOLE VERSUS INJECTION THERAPY IN THE PREVENTION OF REBLEEDING FROM PEPTIC-ULCER WITH VISIBLE VESSEL - A MULTICENTER RANDOMIZED STUDY

Endoscopic injection therapy significantly reduces the risk of bleedin g relapse in patients with digestive hemorrhage due to peptic ulcers a ssociated with a visible vessel. Profound and sustained acid inhibitio n by proton pump inhibitors may generate optimal conditions for clotti ng and prevent bleeding relapse. Over a one-year period, 52 patients p resenting with digestive hemorrhage, in whom emergency endoscopy showe d a peptic ulcer with a non-bleeding visible vessel, were enrolled in a multicenter randomized study comparing oral omeprazole, 40 mg per da y (n = 31) vs adrenaline (1:10 000) plus polidocano1 (1 %) injection a ssociated with oral ranitidine 300 mg per day (n = 21). Rebleeding occ urred in 15/52 (29 %) patients: 8/31 (26 %) in the omeprazole group wi th 6 major hemorrhages (19 %), and in 7/21 (33 %) in the injection gro up with 3 major hemorrhages (14 %); the differences were not significa nt. No difference was observed between omeprazole and injection group in terms of volume of transfused blood (2.03 +/- 1.5 vs 3.1 +/- 0.9 bl ood units), need for hemostatic surgery (9.6 % vs 14.3 %), mortality ( 19.3 % vs 14.3 %) and mean hospital stay (11.5 days both groups). This study suggests that oral omeprazole, 40 mg per day, has an efficacy c omparable to injection therapy in reducing the bleeding relapse from n on bleeding peptic ulcers associated with visible vessel.