Pharmacological Management of Peptic Ulcer Bleeding

Peptic ulcer bleeding (PUB) is the most common cause of non-variceal upper gastrointestinal bleeding, although its incidence is decreasing worldwide. Current epidemiological evidence demonstrates the positive influence of Helicobacter pylori eradication on outcomes, owing to the widespread introduction of proton pump inhibitor (PPI) treatment. However, PUB is still commonly encountered in clinical settings given the increasing indications for nonsteroidal anti-inflammatory drugs, anticoagulants, and antiplatelet agents in the aging population. Regardless of advancements made in the endoscopic approach and pharmacological treatment, upper gastrointestinal bleeding has an inevitable mortality rate ranging from 7% to 11%. Endoscopic treatment is recommended for peptic ulcers with current bleeding, vessel exposure, or clotting. However, the development of effective high-dose PPIs has resulted in a decrease in rebleeding events after endoscopic treatment. Pharmacological management consisting of post-endoscopic treatment was more effective than pre-endoscopic treatment. As PPIs ensure that gastric acidity remains above pH 6, they are essential treatments for PUB. This review aimed to investigate the current strategies for PUB pharmacological management.