Current endoscopic and pharmacological therapy of peptic ulcer bleeding

Area of Science:

• Gastroenterology
• Endoscopic interventions
• Gastrointestinal bleeding management

Background:

• Peptic ulcer bleeding is a major complication of ulcer disease.
• It remains a leading cause of upper gastrointestinal bleeding despite Helicobacter pylori eradication efforts.

Purpose of the Study:

• To review current endoscopic management strategies for peptic ulcer bleeding.
• To highlight the role of combined therapies and adjuncts in achieving hemostasis.

Main Methods:

• Review of endoscopic techniques including injection therapy, mechanical methods (clips), and thermal coagulation.
• Discussion of adjunctive therapies such as proton pump inhibitors (PPIs).

Main Results:

• Large volume epinephrine injection remains a core technology.
• Mechanical clips and thermal methods offer effective hemostasis, especially when combined with injection therapy.
• Proton pump inhibitors enhance clotting and improve outcomes.

Conclusions:

• Combination endoscopic therapy (injection plus mechanical or thermal) is increasingly favored for permanent hemostasis.
• Proton pump inhibitors are crucial for acid inhibition and improving clotting.
• Careful patient and ulcer assessment is vital for managing rebleeding, with surgical consultation readily available.