Comparison of hemostatic effects by route of H2 receptor antagonist administration following endoscopic mucosal resection in patients with neoplastic gastric lesions.
BACKGROUND
To date, there has not been an in-depth investigation to identify differences in the effects of bleeding prevention among different routes of administration of H2 receptor antagonists to treat gastric ulcers following endoscopic mucosal resection (EMR).


OBJECTIVE
To prospectively compare the frequency of bleeding following EMR between patients treated with intravenous (IV) famotidine and those with oral famotidine.


METHODS
Fifty-three patients with neoplastic gastric lesions (33 carcinoma and 20 adenoma) treated by EMR were included. Subjects underwent EMR with circumferential mucosal incision assisted by submucosal injection of sodium hyaluronate (EMRSH), followed by IV or oral (PO) administration of famotidine at a dosage of 40 mg/day for 2 days. Patients with odd ID numbers were assigned to IV therapy (30 cases) while even numbers were given PO therapy (23 cases). Frequencies and endoscopic findings of bleeding during the first 2 days after EMR were examined.


RESULTS
Frequency of bleeding within 2 days after EMR was 3 and 4% in IV and PO patients, respectively, showing no significant difference. No significant difference was seen in the endoscopic findings of bleeding and therapy, either, with respective IV and PO findings at 23 and 26%.


CONCLUSIONS
No significant difference was observed in frequency of bleeding within 2 days after gastric EMR between IV and oral administrations of famotidine.
Satoh
K
K
Department of Gastroenterology, Jichi Medical School, Kawachi-gun, Tochigi, Japan. kiichi@jichi.ac.jp
Yamamoto
H
H
Kawata
H
H
Osawa
H
H
Hanatsuka
K
K
Kita
H
H
Sunada
K
K
Hirasawa
T
T
Yoshizawa
M
M
Ajibe
H
H
Satoh
Y
Y
Sunada
F
F
Sugano
K
K
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000601:surgery; D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000284:Administration, Oral; D000368:Aged; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects; D015738:Famotidine / Q000008:administration & dosage*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D016558:Hemostasis, Endoscopic / Q000009:adverse effects; D006635:Histamine H2 Antagonists / Q000008:administration & dosage*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage; D007262:Infusions, Intravenous; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D012008:Recurrence; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery
D000276:Adjuvants, Immunologic; D006635:Histamine H2 Antagonists; D015738:Famotidine; D006820:Hyaluronic Acid