Acid Reduction After Endoscopic Mucosal Dissection

Endoscopic removal of superficial early gastric cancers or high-grade dysplasia is common. However, endoscopic mucosal resection or dissection leaves large areas of the stomach surface denuded of its mucosal cover and exposes underlying muscular layers. A potential major complication of this procedure is bleeding from the denuded area, either during the procedure or at a later time. Empirical acid-reduction therapy is recommended to reduce acid-induced tissue injury and to enhance hemostasis (e.g., J Gastroenterol Hepatol 2006; 21:1675). Both histamine-2–receptor antagonists (H₂RAs) and proton-pump inhibitors (PPIs) have been used for this purpose, but the efficacy of these medications in lowering subsequent bleeding has not been studied ri…