Document Detail

Practices in peptic ulcer bleeding controversies among university- versus nonuniversity-affiliated gastroenterologists.
MedLine Citation:
PMID:  20431816     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Practices relating to acute peptic ulcer bleeding (APUB) outside of guideline recommendations are unknown.
OBJECTIVE: To evaluate the practices of university-affiliated (UA) versus nonuniversity-affiliated (non-UA) gastroenterologists in controversial APUB issues.
METHODS: Gastroenterologists in Canada were mailed an anonymous questionnaire (January 2008) regarding APUB management.
RESULTS: Responses were received for 281 of the 530 questionnaires mailed (53%). There were no differences between the UA versus non-UA gastroenterologists regarding acid suppression medication and route of administration pre- and postendoscopy (all P>0.05). There were no differences in endoscopic practices between groups regarding large versus small volume injection, endoclip versus combination injection plus coagulation, endoclip versus endoclip plus injection, and management of adherent clots (all P>0.05). There was variability within each group regarding optimal empirical acid suppression pre- and postendoscopy, volume of injection therapy and endoclip use. The non-UA group had longer delays before restarting acetylsalicyclic acid (P=0.08) and warfarin (P=0.02) post-APUB.
CONCLUSIONS: UA and non-UA gastroenterologists have similar practices in acid suppression and endoscopic therapy for controversial APUB issues; however, non-UA gastroenterologists appear more cautious in restarting acetylsalicylic acid and warfarin. Further studies are needed to address the optimal empirical acid suppression pre- and postendoscopy, injection therapy volume, endoclip use, and timing of restarting antiplatelet and anticoagulation therapy.
Justin Cheung; Grant Sawisky; Robert Enns; Michael F Byrne; Qiaohao Zhu; Clarence K W Wong
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Canadian journal of gastroenterology = Journal canadien de gastroenterologie     Volume:  24     ISSN:  0835-7900     ISO Abbreviation:  Can. J. Gastroenterol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-30     Completed Date:  2010-07-06     Revised Date:  2014-01-17    
Medline Journal Info:
Nlm Unique ID:  8807867     Medline TA:  Can J Gastroenterol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  261-5     Citation Subset:  IM    
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MeSH Terms
Academic Medical Centers*
Clinical Competence
Duodenal Ulcer / therapy*
Gastroenterology / methods*
Hemostatic Techniques / utilization*
Hospitals, Special*
Outcome Assessment (Health Care) / methods
Peptic Ulcer Hemorrhage / therapy*
Retrospective Studies
Stomach Ulcer / therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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