How are bleeding peptic ulcers treated?

Updated: Apr 26, 2021
  • Author: BS Anand, MD; Chief Editor: Philip O Katz, MD, FACP, FACG  more...
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The principles of management of bleeding peptic ulcers outlined below are equally applicable to both gastric and duodenal ulcers.

Endoscopic therapy

Upper gastrointestinal (GI) bleeding secondary to a bleeding peptic ulcer is a common medical condition. Endoscopic evaluation of the bleeding ulcer can decrease the duration of the hospital stay by identifying patients at low risk for rebleeding. Moreover, endoscopic therapy reduces the likelihood of recurrent bleeding and decreases the need for surgery.

A large international study demonstrated that following successful endoscopic hemostasis for Forrest IB (oozing) peptic ulcer bleeding, the risk of rebleeding at 72 hours was very low (4.9%) compared with other stigmata of recent hemorrhage, but was similar to that for patients treated with esomeprazole (5.4%) and placebo (4.9%). [39]

Patients can be stratified as having high or low risk for rebleeding depending on the presence or absence of stigmata seen on the initial endoscopic examination.

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