Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding

Abstract

Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding (Review)

Performance of New Thresholds of the Glasgow Blatchford Score in Managing Patients With Upper Gastrointestinal Bleeding

“…Use of pre-endoscopy PPIs is known to reduce the proportion of patients with high-risk stigmata of hemorrhage at index endoscopy and the proportion of patients needing endoscopic therapy. 23 Therefore, the difference in use of pre-endoscopy PPIs between centers could have an impact on the proportion of patients needing intervention. Nevertheless, in the present study the need for hemostatic intervention was lowest in Glasgow, where pre-endoscopy PPIs were not used.…”

The role of endoscopy in the management of acute non-variceal upper GI bleeding

“…22 The analysis found that patients with nonvariceal UGIB administered intravenous PPI therapy prior to endoscopy did not experience any statistically significant differences in the outcomes of mortality, rebleeding, or progression to surgery compared with patients in the control group. However, the analysis did show that before-procedure PPI therapy resulted in significantly reduced rates of high-risk stigmata identified on endoscopy (odds ratio [OR] 0.67; 95% confidence interval [CI], 0.54-0.84) and need for endoscopic therapy (OR 0.68; 95% CI, 0.50-0.93).…”

Improving outcomes from acute upper gastrointestinal bleeding: Table 1

“…A Cochrane meta-analysis of six RCTs including 2223 patients presenting with unselected UGIB comparing PPIs with control administrations (placebo or H 2 receptor antagonists) demonstrated significant reductions in the proportion of patients with high-risk stigmata (HRS) at endoscopy, as well as a reduction in the need for endoscopic therapy 18. Although it did not lead to reductions in the key endpoints of rebleeding, mortality or need for surgical intervention, downstaging of endoscopic stigmata has obvious benefits but has only been able to be demonstrated in cost-effectiveness modelling to date 19.…”