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BACKGROUND: Protonpump inhibitors (PPIs) following endoscopic haemostasis reduce rebleeding ratesin patients with high-risk acute non-variceal upper gastrointestinal bleeding.Many advocate the use of PPIs prior to endoscopy, although its incrementalbenefit is unproven. AIM: To determine if providing PPIs before endoscopyreduces adverse gastrointestinal outcomes in acute non-variceal uppergastrointestinal bleeding patients. METHODS: We performed a retrospectivereview to identify patients presenting to two tertiary care centres with acutenon-variceal upper gastrointestinal bleeding between 1999 and 2004. Subjectsreceiving PPI therapy before endoscopy were compared with those not receivingpre-endoscopic PPI therapy. The primary outcome measure was the development ofany adverse bleeding outcome (rebleeding, surgery for control of bleeding,in-hospital mortality, readmission within 30 days for acute non-variceal uppergastrointestinal bleeding). RESULTS: 385 patients were included in our study[132 (12 intravenous/120 po) pre-endoscopic PPI vs. 253 no pre-endoscopic PPI].Patients receiving pre-endoscopic PPI therapy were significantly less likely todevelop adverse outcomes compared with those not given pre-endoscopic PPIs (25%vs. 13%, P = 0.005). Rebleeding, upper gastrointestinal surgery, mortality andlength of hospital stay were also significantly lower in patients receivingpre-endoscopic PPI. CONCLUSIONS: The use of PPIs before endoscopy significantlyreduces the risk of developing adverse gastrointestinal outcomes in patientswith acute non-variceal upper gastrointestinal bleeding. Future studies arerequired to better characterize this relationship. Leggi l'articolo