High-Dose Oral Omeprazole Versus Continuous Intravenous Pantoprazole in Patients With High-Risk Peptic Ulcer...

Area of Science:

• Gastroenterology
• Pharmacology
• Clinical Medicine

Background:

• The efficacy of high-dose oral omeprazole for peptic ulcer bleeding post-endoscopic hemostasis is not well-established.
• Comparison with intravenous pantoprazole is needed to assess rebleeding risk and gastric pH control.

Purpose of the Study:

• To compare the efficacy of high-dose oral omeprazole versus continuous intravenous (IV) pantoprazole.
• To evaluate rebleeding rates and the percentage of time gastric pH remains above 6.

Main Methods:

• Randomized controlled trial with 1:1 allocation.
• Patients received either 40-mg oral omeprazole twice daily or IV pantoprazole 8 mg/h for 72 hours.
• Gastric pH was monitored for 24 hours; rebleeding assessed at 72 hours and 30 days.

Main Results:

• No significant difference in 72-hour or 30-day rebleeding rates between oral omeprazole and IV pantoprazole groups.
• The oral omeprazole group showed a trend towards higher median gastric pH > 6 (56.3% vs. 27.3%).
• Gastric pH monitoring was completed in 48% of the oral group and 41% of the IV group.

Conclusions:

• High-dose oral omeprazole is a feasible alternative to IV pantoprazole for preventing rebleeding.
• Oral omeprazole may offer advantages in maintaining gastric pH > 6.
• Further research can confirm the benefits of oral omeprazole in managing peptic ulcer bleeding.