Dr Scott Lee and colleagues hypothesized that large volume gastric lavage prior to endoscopy for acute upper gastrointestinal bleeding would improve the quality of endoscopic examination.
Blood retained in the stomach can impair visualization during esophagogastroduodenoscopy.
Patients with acute upper gastrointestinal bleeding and a retained gastric fundic pool during endoscopy may have worse outcomes than patients without a retained fundic pool.
No trials to date have evaluated if large volume gastric lavage prior to endoscopy improves visualization during acute upper gastrointestinal bleeding.
The researchers randomly allocated patients with acute upper gastrointestinal bleeding to receive esophagogastroduodenoscopy alone or large volume tap water gastric lavage prior to esophagogastroduodenoscopy.
|Quality of visualization was not significantly different between groups for the esophagus or duodenum, but was better for the gastric fundus|
|Journal of Clinical Gastroenterology|
The research group then assessed the quality of endoscopic visualization using a 5-point scale.
The researchers compared clinical outcomes for lavaged and nonlavaged patients.
The research team randomly allocated lavage for a total of 39 patients in the trial. In 1 patient, lavage was unsuccessful.
The researchers found that the quality of visualization was not significantly different between groups for the esophagus, gastric antrum, or duodenum but was significantly better for the gastric fundus for patients randomized to lavage.
The team also found that there was no significant difference between groups for ability to define a bleeding source, achieve hemostasis, recurrent bleeding, need for repeat endoscopy, and length of stay or death.
There were no complications.
Dr Lee, speaking on behalf of the group, commented, "Large volume gastric lavage prior to esophagogastroduodenoscopy for acute upper gastrointestinal bleeding is safe and provides better visualization of the gastric fundus."