A new perspective on stress ulcer prophylaxis.
Gastric acid suppression by use of either antacids or histamine H2-receptor antagonist therapy is the mainstay of stress ulcer prophylaxis. Available evidence indicating an antimicrobial role for gastric acid calls for the reevaluation of gastric acid suppression. A pH of greater than 4.0 leads to bacterial overgrowth and colonization of the upper gastrointestinal tract which has been associated with nosocomial pneumonia, bacterial translocation from the gut, systemic sepsis, and multiple-organ failure. The availability of alternative therapy should discourage the routine use of acid-suppression therapy in the critically ill patient.
Sing
R F
RF
Department of Surgery, Graduate Hospital, Philadelphia, PA 19146.
Marino
P L
PL
D000863:Antacids / Q000627:therapeutic use; D004064:Digestive System / Q000382:microbiology; D005744:Gastric Acid / Q000502:physiology; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D013276:Stomach Ulcer / Q000517:prevention & control*; D013312:Stress, Physiological
D000863:Antacids; D006635:Histamine H2 Antagonists