Researchers from Srinagar, Kashmir, India, evaluated the use of omeprazole as an adjuvant therapy to endoscopic combination injection sclerotherapy for treating bleeding peptic ulcer.
They enrolled 166 patients with hemorrhage from duodenal, gastric, or stomal ulcers, and signs of recent hemorrhage, as confirmed by endoscopy.
Some 26 subjects had ulcers with an arterial spurt, 41 had active ooze, 37 had a visible vessel, and 62 patients had an adherent clot.
All patients received endoscopic injection sclerotherapy using 1:10,000 adrenaline and 1% polidocanol. They were then randomly assigned to receive omeprazole (40 mg orally) every 12 hours for 5 days, or an identical-looking placebo.
The outcome measures used were recurrent bleeding, surgery, blood transfusion, and hospital stay.
The team found that 6 (7%) of 82 patients in the omeprazole group had recurrent bleeding, as compared with 18 (21%) in the placebo group.
| Recurrent bleeding after treatment:|
| American Journal of Medicine |
Two patients in the omeprazole group and 7 patients in the placebo group needed surgery to control their bleeding.
One patient in the omeprazole group and 2 patients in the placebo group died.
A total of 29 patients (35%) in the omeprazole group and 61 patients (73%) in the placebo group received blood transfusions.
The average hospital stay was 4.6 days in the omeprazole group and 6.0 days in the placebo group.
Dr Gul Javid, of the Sher-i-Kashmir Institute of Medical Sciences, concluded on behalf of colleagues, "The addition of oral omeprazole to combination injection sclerotherapy decreases the rate of recurrent bleeding for patients with stigmata of recent hemorrhage.
"It also reduces the need for surgery and transfusion, and shortens the hospital stay."