Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 25 November 2017

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Endoscopic hemostasis and proton pump inhibition are associated with improved outcomes in a real life setting

The Canadian Registry on Non-variceal Upper Gastrointestinal Bleeding and Endoscopy has been used to determine the clinical outcomes and explore the roles of endoscopic and pharmacologic therapies in a contemporary real-life setting.

News image

fiogf49gjkf04

Randomly selected patients endoscoped for non-variceal upper gastrointestinal bleeding at 18 community and tertiary care centers between 1999 and 2002 were analyzed.

Covariates and outcomes were defined a priori and 30-day follow-up obtained, with logistic regression models used by researchers, working at several universities across Canada, to identify predictors of outcomes.

A total of 1869 patients were included, with an average age of 66 ± 17 years, 38% of whom were female. All had 2.5 ± 1.6 comorbid conditions, a hemoglobin of 96 ± 27 g/L, with 54% having received a mean of 2.9 ± 1.7 units of blood.

Decreased rebleeding was associated with PPI use
American Journal of Gastroenterology

In 76% of cases, patients underwent endoscopy within 24 hours. Ulcers were most commonly noted (55%).

High risk endoscopic stigmata and endoscopic therapy were reported in 37%, while rebleeding, surgery, and mortality rates were 14.1%, 6.5% and 5.4%, respectively.

The researchers found the use of proton pump inhibitors (85% of patients, mean daily dose 56 ± 53 mg) was significantly and independently associated with decreased rebleeding in all patients, regardless of endoscopic stigmata.

Decreased rebleeding was also associated with endoscopic hemostasis in patients with high-risk stigmata.

Both proton pump inhibitor use and endoscopic therapy were also each independently associated with decreased mortality in patients with high-risk stigmata.

Commenting on their findings, Alan Barkun, one of the report authors, said that the results appear to confirm the protective role of endoscopic therapy in patients with high-risk stigmata.

He added that the results suggest that acute use of proton pump inhibitors may be associated with a reduction of rebleeding in all patients, and lower mortality in patients with high-risk stigmata.

"Independent prospective validation of these observational findings is now required", he said.

Am J Gastroenterol 2004; 99 (7): 1238 - 1246
14 July 2004

Go to top of page Email this page Email this page to a colleague

 24 November 2017 
Osteoporotic fractures in Barrett's esophagus
 24 November 2017 
Center ERCP volume and procedure success
 24 November 2017 
Adipokines and IBD
 23 November 2017 
Pharmacological management of GERD
 23 November 2017 
Incidence of biopsy-verified celiac disease
 23 November 2017 
Distance travelling for rectal cancer outcomes
 22 November 2017 
Challenges of US-trained gastroenterologists when abroad
 22 November 2017 
Surgical treatment delays influence survival in colon cancer
 22 November 2017 
Golimumab in Crohn's disease
 21 November 2017 
Preoperative optimization in IBD patients
 21 November 2017 
Cholangiopathy in critically ill patients
 21 November 2017 
Prepregnancy obesity and maternal mortality
 20 November 2017 
Barriers to hepatitis C treatment
 20 November 2017 
Socioeconomic characteristics in diverticular disease
 20 November 2017 
Endoscopic indices of disease activity for Crohn’s
 17 November 2017 
Food elimination diets for treatment of adults with eosinophilic esophagitis
 17 November 2017 
PPI use and cognitive function in women
 17 November 2017 
Predicting microscopic colitis
 16 November 2017 
NAFLD-hepatocellular carcinoma and survival after orthotopic liver transplant
 16 November 2017 
Prepregnancy obesity and severe maternal morbidity
 16 November 2017 
Celiac disease screening in adult first-degree relatives
 15 November 2017 
Breastfeeding and the risk of IBD
 15 November 2017 
Predicting recurrence after curative rectal cancer surgery
 15 November 2017 
Medication nonadherence and health care costs
 14 November 2017 
Eosinophilic gastroenteritis and colitis
 14 November 2017 
HBV/HCV coinfection and cirrhosis
 14 November 2017 
Sexual dysfunction after rectal cancer surgery
 13 November 2017 
Genetic polymorphisms, fatty acids and ulcerative colitis
 13 November 2017 
Flares after immunomodulator withdrawal in Crohn's
 13 November 2017 
GI bleeding in patients taking non–vitamin K antagonist oral anticoagulants
 10 November 2017 
Thiopurines vs TNF and lymphoma risk in IBD
 10 November 2017 
Drug monitoring of anti-tumour necrosis factor therapy in IBD
 10 November 2017 
Treatment decisions for older patients with colorectal cancer
 09 November 2017 
Quality standards in upper gastrointestinal endoscopy
 09 November 2017 
Irradiated rectal cancer and chemoradiotherapy
 09 November 2017 
Environmental factors and IBD
 08 November 2017 
Prophylaxis of spontaneous bacterial peritonitis
 08 November 2017 
Optimal management of postoperative Crohn's disease
 07 November 2017 
Community Screening for Helicobacter pylori
 07 November 2017 
Early readmission in IBD patients
 07 November 2017 
Mesocolic excision for colon cancer
 06 November 2017 
Food elimination diet for children with eosinophilic esophagitis
 06 November 2017 
Biologic agents and obesity in children with IBD
 06 November 2017 
Liver cancer burden despite extensive use of antiviral agents
 03 November 2017 
Statins and mortality in chronic viral hepatitis
 03 November 2017 
Propofol for outpatient colonoscopy
 03 November 2017 
Asthma and IBD development
 02 November 2017 
Diverticulitis and emergency department burden
 02 November 2017 
Rural residence and risk of IBD
 02 November 2017 
Sexual functioning in Hep C
 01 November 2017 
Autoimmune pancreatitis in children
 01 November 2017 
Heartburn relief in adolescents with GERD
 31 October 2017 
Follow-up of positive results on fecal blood tests
 31 October 2017 
Surveillance in ulcerative colitis and Crohn’s disease
 30 October 2017 
Local recurrence after curative rectal cancer surgery
 30 October 2017 
Low-flow ascites pump in refractory cirrhosis
 30 October 2017 
Medical therapy of patients with pediatric-onset IBD
 27 October 2017 
NAFLD in advanced fibrosis in the USA
 27 October 2017 
Early readmission in cirrhosis after bacterial infections
 26 October 2017 
Predicting response to anti-TNF therapy in Crohn's

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2017 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us