Effect of oral lansoprazole on intragastric pH after endoscopic treatment for bleeding peptic ulcer

Abstract

Objective. Intravenous proton pump inhibitors (PPIs) induce a high intragastric pH and may thereby improve haemostasis in patients with bleeding peptic ulcer. The aim of this study was to investigate whether a similar therapeutic intragastric pH level could be reached when the PPI was administered orally. Material and methods. Twenty-four-hour intragastric pH was measured in patients treated endoscopically for bleeding peptic ulcer (Forrest class I or II). The patients received lansoprazole capsules (90 mg) after successful endoscopic treatment, followed by 30 mg every third hour for 72 h. The primary end-point was the percentage of the 0 to 24-h registration period with an intragastric pH of 6 or higher. Additionally, the total number of patients obtaining an intragastric pH above 6 for 80% or more of the 0 to 24-h period after start of treatment was evaluated. Results. Of the 14 patients included in the study (4 F, mean age 74 years, range 50–84 years), 10 patients had duodenal ulcer and 4 had gastric ulcer; median lowest Hgb: 8.9 mg/ml (range 5.8–12.4), blood transfusions: 2.7 SAG units (range 0–7). In the 0 to 24-h period, the median time duration of pH above 6 was 55% (range 6–99). One out of 14 patients (7%) reached a pH above 6 in at least 80% of this time period. Conclusions. An increase in intragastric pH of therapeutic importance was reached with this oral medication regimen. However, there were large intra-individual differences. Treatment with oral lansoprazole may be a therapeutic alternative to intravenous administration of PPI.

• GI bleeding