PPI before versus after Endoscopy in Treatment of Non-Variceal Upper Gastrointestinal Bleeding and their Impact on 30-Days Clinical Outcome.

Mostafa, Neveen; Ali, Abeer Ahmed

doi:10.21608/jmalexu.2024.288704.1019

PPI before versus after Endoscopy in Treatment of Non-Variceal Upper Gastrointestinal Bleeding and their Impact on 30-Days Clinical Outcome.

Document Type : Original Article

Authors

Neveen Mostafa ¹
Abeer Ahmed Ali ²

¹ Associate professor, Department of Experimental and Clinical Internal Medicine. Medical Research Institute, Alexandria University, Egypt

² Associate professor, Department of Chemical Pathology, Medical Research Institute, Alexandria University.

10.21608/jmalexu.2024.288704.1019

Abstract

Abstract
Background: Acute upper gastrointestinal bleeding is a widespread medical emergency that represents a challenge to healthcare workers. Despite the notable improvement in management choices, there is no difference in mortality rate. Attentive assessment and examination before determining a treatment plan is associated with fewer complications. Deficient management of patients with upper gastrointestinal bleeding may escalate the risk of re-bleeding and other complications. Moreover, the timing of pharmacological and/or endoscopic intervention may influence the patient's outcome and should be precisely assigned to lower the risk of mortality and morbidity.
Aim: To compare the management of upper gastrointestinal bleeding with pharmachological treatment before and after endoscopic intervention on 30 days' incidence of re-bleeding.
Method
Fifty patients presenting with non-variceal upper gastrointestinal bleeding were either treated with proton pump inhibitors as the first line of management or went directly for upper Esophagogastroduodenoscopy to control the bleeding, the impact of either way of treatment on 30 days’ clinical outcome was evaluated.
Results
No difference in 30 days' outcome between the patients who received proton pump inhibitors first before upper Esophagogastroduodenoscopy and the patients who had their endoscopy done first.
Conclusion
Giving proton pump inhibitors before or after doing upper Esophagogastroduodenoscopy in patients with non-variceal upper gastrointestinal bleeding doesn’t change the incidence of re-bleeding, but early endoscopy is associated with better outcomes.
Keywords: Non-variceal, gastrointestinal bleeding, proton pump inhibitors, endoscopy, re-bleeding.

Keywords