Effect of oral omeprazole in reducing re-bleeding in bleeding peptic ulcers: a prospective, double-blind, randomized, clinical trial.
BACKGROUND
Endoscopic therapies and continuous intravenous omeprazole can decrease the morbidity and duration of hospital stay of patients with high-risk peptic ulcer.


OBJECTIVE
To evaluate the role of oral omeprazole in high-risk bleeders.


METHODS
After injection therapy of 160 patients with high-risk peptic ulcer, 80 received oral omeprazole and 80 received placebo, and all were followed up.


RESULTS
One hundred and forty-nine patients (71 omeprazole and 78 placebo) completed the study. Eleven patients were excluded from the study. Thirty-seven (25%) patients had gastric ulcer and 112 (75%) had duodenal ulcer. Fifty-seven (38%) ulcers showed visible vessels, 80 (54%) showed oozing of blood and 12 (8%) showed a spurting artery. Only one patient died (placebo group). The mean hospital stays were 62.8 +/- 28.6 h and 75 +/- 39 h in the omeprazole and placebo groups, respectively (P = 0.032). The mean amounts of blood transfused were 1.13 +/- 1.36 and 1.68 +/- 1.68 bags in the omeprazole and placebo groups, respectively (P = 0.029). The re-bleeding rate was lower in the omeprazole group than in the placebo group (12 vs. 26, respectively; P = 0.022).


CONCLUSIONS
Oral omeprazole is effective in decreasing the hospital stay, re-bleeding rate and the need for blood transfusion in high-risk ulcer bleeders treated with endoscopic injection therapy.
Kaviani
M J
MJ
Gastroenterohepatology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Iran. kavianim@sums.ac.ir
Hashemi
M R
MR
Kazemifar
A R
AR
Roozitalab
S
S
Mostaghni
A-A
AA
Merat
S
S
Alizadeh-Naini
M
M
Yarmohammadi
H
H
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D004311:Double-Blind Method; D004381:Duodenal Ulcer / Q000188:drug therapy*; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage*; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy*; D055502:Secondary Prevention; D013276:Stomach Ulcer / Q000188:drug therapy*; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D009853:Omeprazole