Document Detail

Omeprazole versus ranitidine as adjunct therapy to endoscopic injection in actively bleeding ulcers: a prospective and randomized study.
MedLine Citation:
PMID:  7555936     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND STUDY AIMS: Although high rates of initial hemostasis can be achieved with endoscopic injection therapy in actively bleeding ulcers, the incidence of rebleeding is not negligible. Optimal conditions for clotting may require achieving deep and sustained acid inhibition to avoid the deleterious effect of acid and pepsin secretions on the hemostatic process. The aim of this study was to assess whether omeprazole could improve the efficacy of ranitidine as an adjunct treatment in endoscopic injection therapy to avoid rebleeding. PATIENTS AND METHODS: Eighty-six patients with active arterial bleeding from a peptic ulcer disclosed at emergency endoscopy were included in this prospective trial. All patients received injections of 1:10,000 adrenaline. Subsequently, they were randomized to receive either intravenous omeprazole (n = 45), with an initial dose of 80 mg followed by 40 mg every eight hours for four days and thereafter with oral administration; or ranitidine (n = 41), 50 mg every six hours for 12 to 24 hours and thereafter with oral administration. RESULTS: The two groups were well matched in terms of clinical and endoscopic data. There were no statistically significant differences between the groups with regard to: further bleeding (29% in both groups), need for emergency surgery (20% in the omeprazole group vs. 22% in the ranitidine group), transfusion requirements (2.4 +/- 2.2 vs. 2.2 +/- 2.1 units), length of hospital stay (14.1 +/- 13.9 vs. 15.3 +/- 15.4 days), or mortality (7% vs. 2%). CONCLUSIONS: Our results suggest that omeprazole does not improve the efficacy of ranitidine after endoscopic injection therapy in patients with an active arterial bleeding ulcer.
C Villanueva; J Balanzó; X Torras; S Sáinz; G Soriano; D González; F Vilardell
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Endoscopy     Volume:  27     ISSN:  0013-726X     ISO Abbreviation:  Endoscopy     Publication Date:  1995 May 
Date Detail:
Created Date:  1995-11-21     Completed Date:  1995-11-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  308-12     Citation Subset:  IM    
Department of Gastroenterology, Hospital de La Santa Creu i Sant Pau, Barcelona, Spain.
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MeSH Terms
Anti-Ulcer Agents / administration & dosage,  therapeutic use*
Confidence Intervals
Drug Therapy, Combination
Duodenal Ulcer / complications*,  diagnosis
Hemostasis, Endoscopic* / methods
Injections, Intralesional
Middle Aged
Omeprazole / administration & dosage,  therapeutic use*
Peptic Ulcer Hemorrhage / diagnosis,  therapy*
Prospective Studies
Ranitidine / administration & dosage,  therapeutic use*
Stomach Ulcer / complications*,  diagnosis
Treatment Outcome
Reg. No./Substance:
0/Anti-Ulcer Agents; 66357-35-5/Ranitidine; 73590-58-6/Omeprazole

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