Optimization of acid suppression for patients with peptic ulcer bleeding: an intragastric pH-metry study with omeprazole.
OBJECTIVE
To study whether an intravenous infusion dose of omeprazole (80 mg + 8 mg/h) during 24 h can be subsequently reduced with maintained effect. Second, to study the effect of oral omeprazole 20 mg given once or twice daily up to day 10, after cessation of a 3-day intravenous infusion (80 mg + 8 mg/h).


METHODS
Prospective, randomized, partly blinded study.


METHODS
Twelve Helicobacter pylori(+) patients and 12 H. pylori(-) subjects were included. In part I the patients received omeprazole, 80 mg + 8 mg/h, during 24 h followed by 8, 4 or 2 mg/h. In part II the subjects received 80 mg + 8 mg/h during 3 days followed by 20 mg omeprazole orally, once or twice daily until day 10. Intragastric pH was measured.


RESULTS
All H. pylori(+) patients showed a rapid increase of intragastric pH with a mean intragastric pH of 6.7 during the second half of the first day. After the subsequent dose reduction, the mean pH decreased to 6.1-6.2. Patients continuing on 8 mg/h showed the best results. Likewise, all H. pylori(-) subjects showed a rapid and sustained reduction of intragastric acidity during the infusion. Subsequent dose reduction to 20 mg once daily led to a stable fraction of time with pH > 3 of 72%.


CONCLUSIONS
Omeprazole given as a continuous infusion of 80 mg + 8 mg/h for 72 h followed by omeprazole 20 mg once daily raised the intragastric pH to and above levels alleged to allow haemostasis in patients with peptic ulcer bleeding and subsequent healing of the ulcer.
Hasselgren
G
G
Department of Surgery, Sahlgren University Hospital, Göteborg, Sweden.
Keelan
M
M
Kirdeikis
P
P
Lee
J
J
Röhss
K
K
Sinclair
P
P
Thomson
A B
AB
D000328:Adult; D004381:Duodenal Ulcer / Q000150:complications* / Q000382:microbiology; D004791:Enzyme Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005744:Gastric Acid / Q000378:metabolism*; D016481:Helicobacter Infections / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage* / Q000627:therapeutic use; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy* / Q000382:microbiology; D011446:Prospective Studies
D004791:Enzyme Inhibitors; D009853:Omeprazole