ADJUVANT DRUG THERAPY OF BLEEDING FROM GASTRIC OR DUODENAL ULCER
Abstract
Around 40 persons from each 100,000 inhabitants of all ages suffer every year from gastric or duodenal bleeding ulcer. These patients still have high mortality, between 8 and 10%, regardless of constant advancement of the treatment modalities. The patients with bleeding ulcer should be subjected to endoscopy as soon as possible and local hemostasis should be made by mechanical, chemical or thermic methods. While the patient is waiting for endoscopy, an intravenous infusion of a proton pump inhibitor in high-doses should be started, and then continued for 72 hours. Intravenous administration of erythromycin about an hour before endoscopy increases visibility within the stomach and facilitates endoscopic therapy. The intravenous infusion of proton pump inhibitors should be continued by oral administration of the same drugs during the next 7 weeks, and the patient positive to Helicobacter pylori should receive eradication therapy. In order to achieve successful cure and to prevent bleeding relapse it is of utmost importance to make optimal choice, timing and dosing of drugs that accompany endoscopic diagnostics and therapy.
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