Reoccurrence of Ulcer bleeding after endoscopies
After endoscopic treatment for gastric ulcer about 20% of the patients have developed reocurrent bleedings and a part of them encountered life-endangering problems. According to studies the high levels of acid in the stomach render difficult the plachetar aggregation because of the increased Ph-level. Using antagonists of H2-receptors of histamine intravenous have revealed that the body develops resistance in around 72 hours, and the capacity of reducing acid production decreases.
Another experiment for reducing superior digestive bleeding after endoscopies was to administrate an inhibitor of proton-pump in high doses.
Patients with high gastrointestinal bleeding were exposed to upper digestive endoscopies 24 hours before and also tested for Helicobacter at the same time. Afterwards they were injected with adrenaline and visible blood vessels went through a process of thermo coagulation. This experiment underwent patients with reoccurring SDB (superior digestive bleeding) as well as people without clinical signs of hemorrhage.
Ulcer patients were also submitted to random administration of Omeprazole 80mg i.v. or same dose of placebo followed by intravenous administrations of 8mg per hour of Omeprazole for 72 hours. Patients were precisely monitored for a potential reoccurring bleeding and those without any signs of hemorrhagic danger were released home. Patients with reoccurring superior gastrointestinal bleeding were forced to repeat endoscopies, epinephrine and thermo coagulation.
Omeprazole was prescribed for three further weeks in 20mg per day, oral administration doses after their release from hospital. Also patients diagnosed with Helicobacter need to make a treatment with Amoxicillin and Clarythromicin for a week.
All treated and placebo cases repeated the endoscopies in eight weeks time.
From a number of about 700 people suffering from upper digestive bleeding, about 250 persons were exposed to endoscopic treatment and approximately one half of these underwent random cure with Omeprazole or placebo. The age-medium per group was 65 years. From patients treated with Omeprazole only 10% showed reoccurred bleedings compared to 20% in the placebo group. Hemorrhages appeared in the 3 days period of treatment and a number of patients from each group needed surgical intervention.
The group of patients with active bleeding ulcers contained three cases of reoccurrence in those with Omeprazole treatment and 10 cases in the placebo team. Also the quantity of blood for transfusions was lower in the group undergoing the cure of Omeprazole in the first 30 days of experiment after endoscopies. Fewer patients needed to be hospitalized longer in those with Omeprazole compared with the placebo group.
Five death cases occurred in the first group and 12 in the second one, but none of them were directly induced by digestive hemorrhages.
As a final statement we must admit Omeprazole in patients with bleeding ulcers kept the diseases under control and decreased the number of surgical interventions, blood transfusions and hospitalization days after endoscopies.
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