Comparison of p.o. or i.v. proton pump inhibitors on 72-h intragastric pH in bleeding peptic ulcer.
OBJECTIVE
After successful endoscopic hemostasis in bleeding peptic ulcer, addition of proton pump inhibitors reduce the rate of recurrent bleeding by maintaining intragastric pH at neutral level. The aim of the present study was to evaluate the effect of various proton pump inhibitors given through different routes on intragastric pH over 72 h after endoscopic hemostasis in bleeding peptic ulcer.


METHODS
Ninety consecutive patients who had successful endoscopic therapy of bleeding peptic ulcer underwent 72-h continuous ambulatory intragastric pH study, were randomly assigned to receive p.o. omeprazole 80 mg bolus followed by 40 mg every 12 h for 72 h or i.v. 80 mg omeprazole followed by infusion 8 mg/h for 72 h. Oral pantoprazole 80 mg bolus followed by 80 mg every 12 h for 72 h or i.v. 80 mg pantoprazole followed by infusion of 8 mg/h for 72 h. Oral rabeprazole 80 mg bolus followed by 40 mg every 12 h for 72 h or i.v. 80 mg rabeprazole followed by infusion 8 mg/h for 72 h. Five patients received no treatment after successful endoscopic therapy and underwent 72-h pH study.


RESULTS
Mean 72-h intragastric pH for p.o. omeprazole was 6.56 versus 6.93 for omeprazole infusion (P = 0.48). Mean 72-h intragastric pH for p.o. pantoprazole was 6.34 versus 6.32 for pantoprazole infusion (P = 0.62). Mean 72-h intragastric pH for rabeprazole p.o. was 6.11 versus 6.18 rabeprazole i.v. (P = 0.55). Mean 72-h pH for the no proton pump inhibitor group was 2.04.


CONCLUSIONS
There was no significant difference among various proton pump inhibitors given through different routes on raising intragastric pH above 6 for 72 h after successful endoscopic hemostasis in bleeding peptic ulcer.
Javid
Gul
G
Department of Gastroenterology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, India. gul_javid@rediffmail.com
Zargar
Showkat Ali
SA
U-Saif
Riyaz-
R
Khan
Bashir Ahmad
BA
Yatoo
Ghulam Nabi
GN
Shah
Altaf Hussain
AH
Gulzar
Ghulam Mohammad
GM
Sodhi
Jaswinder Singh
JS
Khan
Mushtaq Ahmad
MA
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D004334:Drug Administration Schedule; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000628:therapy*; D004384:Duodenoscopy; D005260:Female; D005745:Gastric Acidity Determination; D005773:Gastroscopy; D006489:Hemostatic Techniques; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage; D000077402:Pantoprazole; D010438:Peptic Ulcer Hemorrhage / Q000517:prevention & control / Q000628:therapy*; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D064750:Rabeprazole; D012008:Recurrence; D013276:Stomach Ulcer / Q000188:drug therapy / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D064750:Rabeprazole; D000077402:Pantoprazole; D009853:Omeprazole