Help
Subscribe


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

 24 May 2018

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 May 2018 
Precision medicine for tumors
 24 May 2018 
Patient-reported outcome measures in IBD trials
 24 May 2018 
Alcohol consumption and outcomes in drug-induced liver injury
 23 May 2018 
High body mass index is and ulcerative colitis
 23 May 2018 
Management of perianal fistulas in Crohn’s disease
 23 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 22 May 2018 
Worldwide H.pylori prevalence
 22 May 2018 
PPI and risk of stroke
 22 May 2018 
Online tool predicts bowel dysfunction severity prior to anterior resection
 21 May 2018 
Fecal incontinence and quality of life in IBD
 21 May 2018 
PPI use and cognitive decline
 21 May 2018 
Depressive symptoms in IBD youth
 18 May 2018 
Esophageal dilatation in clinical practice 
 17 May 2018 
IBD and later extraintestinal manifestations
 17 May 2018 
Repeat stool DNA testing
 17 May 2018 
IBS and chronic fatigue following GI infection
 16 May 2018 
Factors associated with fecal incontinence
 16 May 2018 
Diagnostic delay in Crohn's disease
 16 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 15 May 2018 
Guidelines for management of Crohn's
 15 May 2018 
New therapies for CDI
 15 May 2018 
Hep B in the Grey Zone
 14 May 2018 
Blood test for the diagnosis of fibrotic NASH
 14 May 2018 
Outcomes at bariatric centers of excellence
 14 May 2018 
Management of perianal fistulas in Crohn’s
 11 May 2018 
Detection of undiagnosed celiac disease
 11 May 2018 
Alcohol consumption and drug-induced liver injury
 10 May 2018 
Colorectal cancer screening
 10 May 2018 
Post‐operative complications in elderly IBD
 10 May 2018 
Fibrosis in patients with chronic hepatitis B
 09 May 2018 
Esophageal dilatation in clinical practice 
 09 May 2018 
Fecal incontinence
 09 May 2018 
Health problems and IBS
 07 May 2018 
Omitting antibiotics in uncomplicated acute diverticulitis
 07 May 2018 
Health problems and IBS
 07 May 2018 
Assessment of diminutive colorectal polyps
 04 May 2018 
Factors associated with fecal incontinence
 04 May 2018 
National Institutes of Health workshop and obesity
 04 May 2018 
Colorectal cancer screening and ethnic inequities
 03 May 2018 
Gastrointestinal ultrasound in IBD
 03 May 2018 
Ultransonography in postsurgical recurrence in Crohn's
 02 May 2018 
Hep C antiviral treatment and liver cancer risk
 02 May 2018 
Symptom assessment in cirrhotic ascites
 02 May 2018 
Chronic Hep B
 01 May 2018 
European guidelines on pancreatic cystic neoplasms
 01 May 2018 
Interferon‐free regimens in Hep C
 01 May 2018 
Age at IBD onset and extraintestinal complications
 30 April 2018 
Formula for preterm infants
 30 April 2018 
Primary antibiotic resistance and sequential therapy for H. pylori
 27 April 2018 
Eastern and western practices for endoscopic resection of colorectal lesions
 27 April 2018 
Anxiety scale for chronic esophageal disease
 27 April 2018 
Disease activity in eosinophilic esophagitis
 26 April 2018 
Obesity and physical activity in diverticulosis
 26 April 2018 
Primary sclerosing cholangitis in the USA
 25 April 2018 
Aspirin and pancreatic cancer
 25 April 2018 
Central mediators of irinotecan-induced steatohepatitis
 25 April 2018 
Neuroimaging in Hep C
 24 April 2018 
Scoring system identifies cancer risk in Barrett's
 24 April 2018 
Microbiome in athletes vs sedentary subjects
 23 April 2018 
Genome-wide study on HBV-related acute-on-chronic liver failure

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us