A head to head comparison of oral vs intravenous omeprazole for patients with bleeding peptic ulcers with a clean base, flat spots and adherent clots.
OBJECTIVE
To compare the effect of intravenous and oral omeprazole in patients with bleeding peptic ulcers without high-risk stigmata.


METHODS
This randomized study included 211 patients [112 receiving iv omeprazole protocol (Group 1), 99 receiving po omeprazole 40 mg every 12 h (Group 2)] with a mean age of 52.7. In 144 patients the ulcers showed a clean base, and in 46 the ulcers showed flat spots and in 21 old adherent clots. The endpoints were re-bleeding, surgery, hospital stay, blood transfusion and death. After discharge, re-bleeding and death were re-evaluated within 30 d.


RESULTS
The study groups were similar with respect to baseline characteristics. Re-bleeding was recorded in 5 patients of Group 1 and in 4 patients of Group 2 (P = 0.879). Three patients in Group 1 and 2 in Group 2 underwent surgery (P = 0.773). The mean length of hospital stay was 4.6 +/- 1.6 d in Group 1 vs 4.5 +/- 2.6 d in Group 2 (P = 0.710); the mean amounts of blood transfusion were 1.9 +/- 1.1 units in Group 1 vs 2.1 +/- 1.7 units in Group 2 (P = 0.350). Four patients, two in each group died (P = 0.981). After discharge, a new bleeding occurred in 2 patients of Group 1 and in 1 patient of Group 2, and one patient from Group 1 died.


CONCLUSIONS
We demonstrate that the effect of oral omeprazole is as effective as intravenous therapy in terms of re-bleeding, surgery, transfusion requirements, hospitalization and mortality in patients with bleeding ulcers with low risk stigmata. These patients can be treated effectively with oral omeprazole.
Yilmaz
Serif
S
Dicle University Faculty of Medicine, Department of Gastroenterology, Diyarbakir, Turkey. drserif@dicle.edu.tr
Bayan
Kadim
K
Tüzün
Yekta
Y
Dursun
Mehmet
M
Canoruç
Fikri
F
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage* / Q000627:therapeutic use*; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D012008:Recurrence; D016019:Survival Analysis
D000897:Anti-Ulcer Agents; D009853:Omeprazole