Role of Intravenous Omeprazole on Non-variceal Upper Gastrointestinal Bleeding After Endoscopic Treatment: a Comparative Study

Aim: To evaluate and compare the clinical efficacy of intravenous omeprazole versus intravenous ranitidine therapy for the treatment of non-variceal upper gastrointestinal (UGI) bleeding after endoscopic therapy. Methods: 108 patients (72 males and 36 females) admitted with non-variceal UGI bleeding in the Intensive Care Unit of the University Hospital of Durres, Albania, from 2004 to 2008, were included in the study. Patients with gastro-duodenal malignancy and those who were previously receiving anti-secretory drugs were excluded. All patients were treated endoscopically by injecting epinephrine (diluted 1:10.000) followed by ethanol and subsequently were randomized to receive either intravenous omeprazole (with an initial dose of 80 mg, followed by 8 mg/h infusion [n = 54]), or intravenous ranitidine (100 mg bolus, followed by 100 mg boluses every 6 hours for the next 72 hours [n = 54]). Results: The re-bleeding rate 72 hours after endo-scopic treatment was lower in the omeprazole group than in the ranitidine group (6 vs. 14 patients, respectively; OR=3.4; 95% CI =1.1 -7.2; P<0.01). Less volume of blood transfusion was needed for the omeprazole group than for the ranitidine one (1.1 ± 1.8 units vs. 2.3 ± 2.9 units, P=0.03). The hospitalization period was shorter among patients treated with omeprazole than among those treated with ranitidine (5.4 ± 2.6 days vs. 6.8 ± 3.3 days, respectively; P=0.04). The need for surgery and the mortality rate were not statistically different between the two groups. Conclusion: After endoscopic treatment of non-variceal UGI bleeding, intravenous omeprazole reduced the risk of recurrent bleeding, decreased the need for blood transfusion and shortened the period of hospitalization. Intravenous omeprazole should be used in patients with non-variceal UGI bleeding after effective endoscopic treatment.