[Does the antisecretory agent used affect the evolution of upper digestive hemorrhage?]

Area of Science:

• Gastroenterology
• Pharmacology

Background:

• Upper gastrointestinal bleeding (UGIB) is a significant clinical issue, often stemming from peptic ulcers.
• Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently implicated in the etiology of peptic ulcer disease and subsequent bleeding.

Purpose of the Study:

• To compare the efficacy of omeprazole versus ranitidine in managing non-variceal upper gastrointestinal bleeding.
• To assess the impact of these treatments on key morbidity and mortality indicators.

Main Methods:

• A prospective, randomized, open-label study involving 519 patients with peptic origin UGIB.
• Patients received either intravenous ranitidine or omeprazole, with standardized dosing protocols.
• Endoscopy was performed within 24 hours; patients undergoing endoscopic sclerotherapy were excluded.

Main Results:

• Duodenal ulcers were the most frequent cause of bleeding, with a high incidence of prior NSAID use (54.5%).
• No statistically significant differences were observed between the omeprazole and ranitidine groups regarding bleeding stigmata, transfusion needs, recurrence, emergency surgery, hospital stay duration, or mortality.

Conclusions:

• Omeprazole and ranitidine demonstrate comparable efficacy in treating upper gastrointestinal bleeding of peptic origin.
• The choice between these agents may not significantly impact patient outcomes for this condition.