Management Options for Patients with Ulcer Hemorrhage
Authors: James Y.W. Lau, Joseph J.Y. Sung
Journal: Annals of Internal Medicine (2004)

Letters18 May 2004Management Options for Patients with Ulcer HemorrhageJames Y.W. Lau, MD, FRCS and Joseph J.Y. Sung, MD, PhD, FRCP, FRACPJames Y.W. Lau, MD, FRCSFrom Prince of Wales Hospital, Shatin, Hong Kong.Search for more papers by this author and Joseph J.Y. Sung, MD, PhD, FRCP, FRACPFrom Prince of Wales Hospital, Shatin, Hong Kong.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-10-200405180-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Jensen (1) concurred with the conclusion of our randomized study (2) that intravenous proton-pump inhibitor (PPI) infusion as an adjunct to endoscopic therapy was superior to infusion alone for treating ulcers with nonbleeding visible vessels and adherent clots. He also commented that the rate of recurrent bleeding among patients who received intravenous PPI infusion alone was somewhat lower than the rates reported in series that were conducted in the era of H2-receptor antagonists and that used variable techniques and vigor for treating these ulcers (3). Many other factors, such as the size and depth of these ...References1. Jensen DM. Treatment of patients at high risk for recurrent bleeding from a peptic ulcer [Editorial]. Ann Intern Med. 2003;139:294-5. [PMID: 12965985] LinkGoogle Scholar2. Sung JJ, Chan FK, Lau JY, Yung MY, Leung WK, Wu JC, et al . The effect of endoscopic therapy in patients receiving omeprazole for bleeding ulcers with nonbleeding visible vessels or adherent clots: a randomized comparison. Ann Intern Med. 2003;139:237-43. [PMID: 12965978] LinkGoogle Scholar3. Lau JY, Chung SC, Leung JW, Lo KK, Yung MY, Li AK. The evolution of stigmata of hemorrhage in bleeding peptic ulcers: a sequential endoscopic study. Endoscopy. 1998;30:513-8. [PMID: 9746158] CrossrefMedlineGoogle Scholar4. Daneshmend TK, Hawkey CJ, Langman MJ, Logan RF, Long RG, Walt RP. Omeprazole versus placebo for acute upper gastrointestinal bleeding: randomised double blind controlled trial. BMJ. 1992;304:143-7. [PMID: 1737157] CrossrefMedlineGoogle Scholar5. Khuroo MS, Yattoo GN, Javid G, Khan BA, Shah AA, Gulzar GM, et al . A comparison of omeprazole and placebo for bleeding peptic ulcer. N Engl J Med. 1997;336:1054-8. [PMID: 9091801] CrossrefMedlineGoogle Scholar6. Jensen DM, Kovacs TO, Jutabha R, Machicado GA, Gralnek IM, Savides TJ, et al . Randomized trial of medical or endoscopic therapy to prevent recurrent ulcer hemorrhage in patients with adherent clots. Gastroenterology. 2002;123:407-13. [PMID: 12145792] CrossrefMedlineGoogle Scholar7. Bleau BL, Gostout CJ, Sherman KE, Shaw MJ, Harford WV, Keate RF, et al . Recurrent bleeding from peptic ulcer associated with adherent clot: a randomized study comparing endoscopic treatment with medical therapy. Gastrointest Endosc. 2002;56:1-6. [PMID: 12085028] CrossrefMedlineGoogle Scholar8. Lau JY, Sung JJ, Lee KK, Yung MY, Wong SK, Wu JC, et al . Effect of intravenous omeprazole on recurrent bleeding after endoscopic treatment of bleeding peptic ulcers. N Engl J Med. 2000;343:310-6. [PMID: 10922420] CrossrefMedlineGoogle Scholar9. Lee KK, You JH, Wong IC, Kwong SK, Lau JY, Chan TY, et al . Cost-effectiveness analysis of high-dose omeprazole infusion as adjuvant therapy to endoscopic treatment of bleeding peptic ulcer. Gastrointest Endosc. 2003;57:160-4. [PMID: 12556776] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: James Y.W. Lau, MD, FRCS; Joseph J.Y. Sung, MD, PhD, FRCP, FRACPAffiliations: From Prince of Wales Hospital, Shatin, Hong Kong. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTreatment of Patients at High Risk for Recurrent Bleeding from a Peptic Ulcer Dennis M. Jensen The Effect of Endoscopic Therapy in Patients Receiving Omeprazole for Bleeding Ulcers with Nonbleeding Visible Vessels or Adherent Clots Joseph J.Y. Sung , Francis K.L. Chan , James Y.W. Lau , Man-Yee Yung , Wai-Keung Leung , Justin C.Y. Wu , Enders K.W. Ng , and S.C Sydney Chung Metrics 18 May 2004Volume 140, Issue 10Page: 845-846KeywordsArteriesClinical trialsEndoscopyHemorrhageHemostasisIntravenous injectionsProton pump inhibitorsUlcers ePublished: 18 May 2004 Issue Published: 18 May 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...