The Role of Proton Pump Inhibitors in the Management of Upper Gastrointestinal Bleeding

Grigorios I. Leontiadis, Colin Howden

Research output: Contribution to journalReview article

26 Citations (Scopus)

Abstract

This article summarizes and appraises the evidence from randomized controlled trials (RCT) and meta-analyses of RCTs on the role of proton pump inhibitors (PPIs) in non-variceal upper gastrointestinal bleeding, with a specific emphasis on peptic ulcer bleeding. PPIs have an established role in the management of endoscopically documented peptic ulcer bleeding. PPIs, compared with H2-receptor antagonists or placebo, consistently reduce re-bleeding rates. All-cause mortality is reduced in patients with high risk endoscopic signs and in Asian populations. The optimal dose and route of PPI administration in peptic ulcer bleeding has not yet been defined. The role of PPIs prior to endoscopy in patients presenting with non-variceal upper gastrointestinal bleeding is still somewhat controversial; PPIs reduce the proportion of patients with high risk endoscopic signs and may reduce the requirement for endoscopic hemostatic therapy at index endoscopy, but there is no demonstrable effect on mortality, re-bleeding or surgical interventions.

Original languageEnglish (US)
Pages (from-to)199-213
Number of pages15
JournalGastroenterology Clinics of North America
Volume38
Issue number2
DOIs
StatePublished - Jun 1 2009

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Proton Pump Inhibitors
Hemorrhage
Peptic Ulcer
Endoscopy
Histamine H2 Receptors
Mortality
Hemostatics
Meta-Analysis
Randomized Controlled Trials
Placebos
Population

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

The Role of Proton Pump Inhibitors in the Management of Upper Gastrointestinal Bleeding. / Leontiadis, Grigorios I.; Howden, Colin.

In: Gastroenterology Clinics of North America, Vol. 38, No. 2, 01.06.2009, p. 199-213.

Research output: Contribution to journalReview article

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