Comparison of Oral Omeprazole Administration with Endoscopic Ethanol Injection Therapy for the Prevention of Recurrent Bleeding from Peptic Ulcers with Non-Bleeding Visible Vessels or Fresh Adherent Clots : A Prospective Randomized Trial

Lee, Han Chu; Jung, Sung Ae; Jung, Hye Kyung; Son, Hye Young; Yi, Sun Young; Kim, Doe Young; Moon, Il Hwan

Abstract

BACKGROUND/AIMS: Omeprazole is a potent inhibitor of gastric acid secretion. Recently, it was reported that oral omeprazole therapy reduced the rate of rebleeding in patients with non-bleeding visible vessels or adherent clots. The aim of this study was to ascertain whether oral omeprazole administration can be an alternative to endoscopic injection therapy for peptic ulcers with stigmata of rebleeding.
METHODS
Seventy-six patients with peptic ulcer bleeding who had endoscopic findings of non-bleeding visible vessels or fresh adherent clots were randomly assigned to oral omeprazole (40 mg every 12 hours) therapy or endoscopic ethanol injection therapy. Both groups were homogeneous in all clinical and endoscopic parameters.
RESULTS
The rebleeding rates were 25% in the group of omeprazole therapy and 20% in the group of endoscopic injection therapy. The rebleeding rates with clinical significance were 13.9% and 12.5%, respectively. There was no significant difference in rebleeding rate, requirement of surgery, blood transfusion units, and mortality rate.
CONCLUSIONS
Oral omeprazole administration is comparable to endoscopic ethanol injection therapy for the prevention of rebleeding in patients with non-bleeding visible vessels or adherent clots.