Managing Patients with Nonvariceal Upper Gastrointestinal Bleeding

Angelo Andriulli; Vito Annese; Gioacchino Leandro

doi:10.7326/0003-4819-141-1-200407060-00027

Letters |6 July 2004

Managing Patients with Nonvariceal Upper Gastrointestinal Bleeding

Angelo Andriulli, MD; Vito Annese, MD; Gioacchino Leandro, MD

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TO THE EDITOR:

We congratulate the members of the Nonvariceal Upper GI Bleeding Consensus Conference Group for their guidelines on managing patients with nonvariceal bleeding (1). We disagree, however, with recommendation 17, which stresses the value of an intravenous bolus followed by continuous infusion of proton-pump inhibitors for decreasing rebleeding in patients who have undergone successful endoscopic therapy. The statement is ambiguous and only partially true.

In the 4 trials cited by the authors as confirmatory evidence (2-5), high-dose continuous infusions of proton-pump inhibitors administered in combination with endoscopic therapy were compared with endoscopic therapy and placebo (2)...

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2004 American College of Physicians

Letters |6 July 2004

Managing Patients with Nonvariceal Upper Gastrointestinal Bleeding

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Letters |6 July 2004

Managing Patients with Nonvariceal Upper Gastrointestinal Bleeding

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