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Titolo:
The role of acid suppressants in upper gastrointestinal ulcer bleeding
Autore:
van Leerdam, ME; Rauws, EAJ;
Indirizzi:
Univ Amsterdam, Acad Med Ctr, Dept Gastroenterol & Hepatol, NL-1105 AZ Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands NL-1105 AZ Z Amsterdam, Netherlands
Titolo Testata:
BEST PRACTICE & RESEARCH IN CLINICAL GASTROENTEROLOGY
fascicolo: 3, volume: 15, anno: 2001,
pagine: 463 - 475
SICI:
1521-6918(200106)15:3<463:TROASI>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLACEBO-CONTROLLED MULTICENTER; SUCCESSFUL ENDOSCOPIC THERAPY; RANDOMIZED COMPARATIVE TRIAL; 24-HOUR INTRAGASTRIC PH; PEPTIC-ULCER; INTRAVENOUS OMEPRAZOLE; INJECTION THERAPY; PRIMED INFUSIONS; DUODENAL-ULCER; HEMORRHAGE;
Keywords:
peptic ulcer haemorrhage; acid secretion; H-2-receptor antagonist; proton pump inhibitor;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
47
Recensione:
Indirizzi per estratti:
Citazione:
M.E. van Leerdam e E.A.J. Rauws, "The role of acid suppressants in upper gastrointestinal ulcer bleeding", BEST PR RES, 15(3), 2001, pp. 463-475

Abstract

Re-bleeding and mortality remain significant in peptic ulcer haemorrhage despite the widespread use of endoscopic therapy. The acidic gastric environment interferes with coagulation. In vitro studies show that an intragastric pH of above 6 results in normal blood coagulation and platelet function. Because of induced tachyphylaxis, H-2-receptor antagonists are not able to maintain a high pH. In addition, in randomized trials using H-2-receptor antagonists, there was no reduction in re-bleeding and mortality. High-dose intravenous proton pump inhibitors are capable of maintaining a pH above 6. Four randomized trials, using high-dose intravenous proton pump inhibitors,significantly improved the outcome (in terms of a reduction in rebleeding and surgery) in patients with peptic ulcer haemorrhage. Mortality was, however, not reduced. The additional effect of acid-suppressant agents after successful endoscopic therapy is limited to the reduction of re-bleeding and need for surgery, with no effect on mortality.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/02/20 alle ore 08:06:34