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Treatment of upper gastrointestinal bleeding consists of resuscitation, endoscopic hemostasis, and acid suppression to stabilize clots. Past studies of proton-pump inhibitor (PPI) treatment for acute upper GI bleeding have yielded differing results; most notably, studies in Asia have shown effectiveness, whereas studies in Western Europe and North America have had mixed results. These differences are thought to be explained by genetic variations in PPI metabolism and regional variations in Helicobacter pylori prevalence.
In a double-blind study conducted at 91 emergency departments in Asia, Europe, and Africa, researchers randomized 764 patients with single bleeding peptic ulcers to receive intravenous esomeprazole (80-mg bolus within 30 min…