Loading...
Results of multiple studies and meta-analyses have demonstrated that prompt high-dose omeprazole therapy reduces the rate of rebleeding in patients with bleeding peptic ulcers and endoscopic stigmata for rebleeding (i.e., active bleeding or nonbleeding visible vessel). However, the existing data do not show a similar effect in patients with low-risk endoscopic findings (i.e., clean-base, flat pigmented lesions). The conundrum is that endoscopy is required to determine whether proton-pump–inhibitor (PPI) therapy is indicated. The role of routine administration of high-dose intravenous PPIs at the time of admission to the emergency department, before endoscopy, for all patients with upper gastrointestinal bleeding (UGIB) is controversial.
Inve…