title: Comparison of adjuvant therapies by an H2-receptor antagonist and a proton pump inhibitor after endoscopic treatment in hemostatic management of bleeding gastroduodenal ulcers.
abstract: OBJECTIVE
  Upper gastrointestinal bleeding is often associated with a higher risk of serious blood loss. Both H2-receptor antagonists and proton pump inhibitors are commonly given intravenously for endoscopic hemostatic therapies. We compared the effects of a H2-receptor antagonist (famotidine) and a proton pump inhibitor (omeprazole) injected during the early phase (the first 3 days) on cessation of bleeding and prevention of its recurrence in patients who underwent endoscopic therapy for gastroduodenal ulcer bleeding.
  
  
  METHODS
  Consecutive patients who were hospitalized at our clinic with bleeding gastroduodenal ulcers and underwent endoscopic therapy were randomly assigned to receive injections of famotidine, omeprazole, or both. Injection of acid suppressants was switched on the fourth day to the oral administration of omeprazole continued for 8 weeks.
  
  
  RESULTS
  Over a 25-month period, 116 patients were enrolled. The overall success rate for endoscopic hemostasis was 115/116 (99.1%). The success rate of hemostasis and prevention of recurrent ulcer bleeding by type of acid suppressant following endoscopic hemostasis was 39/40 (97.5%) for Group 1 (3-day omeprazole administration), 35/37 (94.6%) for Group 2 (3-day famotidine administration), and 38/39 (97.4%) for Group 3 (1-day famotidine and then 2-day omeprazole administration), yielding an overall rate of 112/116 (96.6%). No significant difference in the hemostatic effect was observed among the groups. There were also no differences in the duration of hospital days and the number of fasting days between the three groups.
  
  
  CONCLUSIONS
  Famotidine and omeprazole injected during the early phase of a bleeding ulcer may have similar effects to an adjuvant therapy for preventing rebleeding from endoscopically treated upper gastrointestinal bleeding in Japanese patients.
authors.affiliation: Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan. sakurada@saitama-med.ac.jp
authors.forename: Tomoya
authors.initials: T
authors.lastname: Sakurada
authors.forename: Junichi
authors.initials: J
authors.lastname: Kawashima
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Ariyama
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Kani
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Takabayashi
authors.forename: Shino
authors.initials: S
authors.lastname: Ohno
authors.forename: Shingo
authors.initials: S
authors.lastname: Kato
authors.forename: Koji
authors.initials: K
authors.lastname: Yakabi
mesh_terms: D017024:Chemotherapy, Adjuvant; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D015738:Famotidine / Q000627:therapeutic use*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D016558:Hemostasis, Endoscopic; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D007902:Length of Stay; D008297:Male; D009853:Omeprazole / Q000627:therapeutic use*; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy / Q000601:surgery*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D055502:Secondary Prevention
chemical_list: D004791:Enzyme Inhibitors; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D015738:Famotidine; D009853:Omeprazole