Effect of oral omeprazole in reducing re‐bleeding in bleeding peptic ulcers: a prospective, double‐blind, randomized, clinical trial

Summary Background : Endoscopic therapies and continuous intravenous omeprazole can decrease the morbidity and duration of hospital stay of patients with high‐risk peptic ulcer. Aim : To evaluate the role of oral omeprazole in high‐risk bleeders. Methods : After injection therapy of 160 patients with high‐risk peptic ulcer, 80 received oral omeprazole and 80 received placebo, and all were followed up. Results : One hundred and forty‐nine patients (71 omeprazole and 78 placebo) completed the study. Eleven patients were excluded from the study. Thirty‐seven (25%) patients had gastric ulcer and 112 (75%) had duodenal ulcer. Fifty‐seven (38%) ulcers showed visible vessels, 80 (54%) showed oozing of blood and 12 (8%) showed a spurting artery. Only one patient died (placebo group). The mean hospital stays were 62.8 ± 28.6 h and 75 ± 39 h in the omeprazole and placebo groups, respectively ( P = 0.032). The mean amounts of blood transfused were 1.13 ± 1.36 and 1.68 ± 1.68 bags in the omeprazole and placebo groups, respectively ( P = 0.029). The re‐bleeding rate was lower in the omeprazole group than in the placebo group (12 vs. 26, respectively; P = 0.022). Conclusion : Oral omeprazole is effective in decreasing the hospital stay, re‐bleeding rate and the need for blood transfusion in high‐risk ulcer bleeders treated with endoscopic injection therapy.