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High-dose intravenous proton-pump inhibitor (PPI) treatment can reduce rebleeding after endoscopic therapy in patients with high-risk lesions. Some studies suggest that oral PPI treatment may have a similar effect.
Investigators in Hong Kong compared 30-day rebleeding rates in patients randomized to receive intravenous (IV) versus oral high-dose PPI treatment after successful endoscopic therapy for bleeding peptic ulcers. One group of 118 patients received 80 mg of esomeprazole, followed by 8 mg/h intravenously and oral placebo capsules every 12 hours for 72 hours. Another group of 126 patients received 40 mg of oral esomeprazole every 12 hours and an intravenous placebo bolus and drip for 72 hours.
Rebleeding rates were similar in the IV-PPI…