Intravenous omeprazole prevents rebleeding in peptic ulcer patients with a non-bleeding visible vessel: a preliminary report of a randomized controlled study

Abstract

Background: In patients with peptic ulcer bleeding, acid can enhance platelet disaggregation and cause lysis of the clot. Omeprazole, a potent acid suppressor, may be helpful in reducing their rebleeding rate.

Methods: Between March and October 1994, 40 patients with a non-bleeding, visible vessel (NBVV) at ulcer bases were enrolled for study. They were randomized into four groups. Group 1 (n = 10) patients received cimetidine 300mg intravenously (i.v.) q6h; Group II (n = 10) patients received heater probe thermocoagulation therapy and cimetidine 300mg i.v. q6h; Group III (n = 10) patients received omeprazole 40mg intravenous bolus initially followed by 40mg i.v. qd and Group IV (n = 10) patients received omeprazole 40mg intravenous bolus initially followed by 40mg i.v. q12h. Endoscopic examination was done for follow-up, daily, for 1-3 days.

Results: Preliminary results showed that the age, initial hemoglobin, ulcer size as well as NBVV size in Groups I-IV were not significantly different (p < 0.05). The rebleeding rates were 40% in Group I, 20% in Group II, 20% in Group III and 0% in Group IV, (p < 0.05 when Group IV is compared with Group I).

Conclusions: Intravenous omeprazole 40mg given q12h can reduce the rebleeding rate of patients with a NBVV.