Comparison of the efficacy of octreotide, vasopressin, and omeprazole in the control of acute bleeding in patients with portal hypertensive gastropathy: a controlled study.

Abstract

BACKGROUND:

Portal hypertensive gastropathy is an important complication of liver cirrhosis and it contributes to acute gastric bleeding. Effective management of this condition remains a clinical challenge. We assessed and compared the efficacy of octreotide, vasopressin, and omeprazole in the treatment of acute bleeding in patients with portal hypertensive gastropathy.

METHODS:

Sixty-eight patients with portal hypertensive gastropathy were randomized into Octreotide, Vasopressin, and Omeprazole groups. Bleeding was monitored by observing the contents of the nasogastric tube. Blood transfusion requirements and side-effects of drugs were recorded. Repeat endoscopies were scheduled 2 weeks after treatment.

RESULTS:

Complete bleeding control after 48 h of drug infusion was achieved in all patients receiving octreotide (100%), 14/22 patients receiving vasopressin (64%), and 13/22 patients receiving Omeprazole (59%). Octreotide required much less time and significantly fewer blood transfusions to control bleeding. Patients receiving vasopressin experienced more side-effects than those receiving octreotide and omeprazole. In the 17 patients whose bleeding was not controlled within 48 h by either vasopressin or omeprazole, complete bleeding control was achieved by combined use of these two agents. Follow-up endoscopy showed dramatic improvement in gastric mucosal erosions, superficial ulceration and erythema.

CONCLUSIONS:

Octreotide appeared to be more effective in controlling acute bleeding in patients with hypertensive gastropathy, with significantly rapid action, smaller transfusion requirements, and minor side-effects. Simultaneous administration of vasopressin and omeprazole appeared to have additive effects.

• Authors: Yongning Zhou, Liang Qiao, Jing Wu, Haiwen Hu, Caipu Xu
• Journal: Journal of gastroenterology and hepatology (J Gastroenterol Hepatol) Vol. 17 Issue 9 Pg. 973-9 (Sep 2002) ISSN: 0815-9319 [Print] Australia
• PMID: 12167118 (Publication Type: Clinical Trial, Comparative Study, Evaluation Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright 2002 Blackwell Publishing Asia Pty Ltd

Chemical References

• Enzyme Inhibitors
• Hemostatics
• Vasopressins
• Omeprazole
• Octreotide

Topics

• Adult
• Aged
• Drug Evaluation
• Enzyme Inhibitors (therapeutic use)
• Esophageal and Gastric Varices (drug therapy, etiology)
• Female
• Gastrointestinal Hemorrhage (drug therapy, etiology)
• Gastroscopy
• Hemostatics (therapeutic use)
• Humans
• Hypertension, Portal (complications, drug therapy)
• Male
• Middle Aged
• Octreotide (therapeutic use)
• Omeprazole (therapeutic use)
• Prospective Studies
• Treatment Outcome
• Vasopressins (therapeutic use)