Somatostatin and ranitidine in the treatment of non-variceal upper gastrointestinal bleeding: A prospective, randomized, double-blind, controlled study

Background/Aims: The aim of this study was to compare the efficacy of somat ostatin vs. ranitidine in controlling acute non-variceal gastrointestinal b leeding. Methodology: A total of 48 patients with acute upper gastrointestinal bleed ing due to duodenal or gastric ulcer were divided into 2 groups. Group I co nsisted of 15 patients with Forrest IB and Group II consisted of 30 patient s with Forrest II. Two regimens were randomly allocated to all patients wit hin half an hour after the endoscopic procedure: 1) somatostatin-UCB 250mcg IV bolus followed by continuous IV infusion at a rate of 6mg/d for 72h, or 2) ranitidine 300mg/d by continuous IV infusion for 72h. Results: In Group I, although mean blood transfusion requirements (no. of u nits) were lower in patients treated with somatostatin than in those treate d with ranitidine,this was not statistically significant (mean+/-SD: 2.56+/ -3.05 vs. 5.17+/-4.96, respectively; P>0.05); the time of bleeding stop was shorter in the somatostatin group than in the ranitidine group (mean+/-SD: 3.24+/-2.45 vs. 11.25+/-11.63, respectively; P=0.0383). The rebleeding and the mortality rates did not differ between the treatment groups in both Gr oup I and Group II. Conclusions: Somatostatin is more effective than ranitidine in controlling acute non-variceal gastrointestinal bleeding in patients with Forrest IB bl eeding activity. Somatostatin has no additional benefit in those with Forre st II bleeding activity.