Critical review of acid suppression in nonvariceal, acute, uppergastrointestinal bleeding.
Nonvariceal, upper gastrointestinal (GI) bleeding is a very common source of morbidity and mortality. The concept of ulcer clot dissolution being facilitated by a low gastric pH has allowed us to better understand the pathophysiology of nonvariceal upper GI bleeding. Placebo-controlled trials have shown the benefit of oral proton pump inhibitor administration in contrast to H(2) receptor antagonists. Furthermore, our recent experience with intravenous proton pump inhibitors has reinforced these observations.
Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alta., Canada. bruce.yacyshyn@ualberta.ca
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Yacyshyn
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Thomson
D000208:Acute Disease; D016099:Endoscopy, Gastrointestinal; D005744:Gastric Acid / Q000378:metabolism / Q000502:physiology; D005745:Gastric Acidity Determination; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000503:physiopathology* / Q000628:therapy; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D006863:Hydrogen-Ion Concentration; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy / Q000628:therapy; D054328:Proton Pump Inhibitors; D016032:Randomized Controlled Trials as Topic
D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors