Proton Pump Inhibitors for Acute Upper Gastrointestinal Bleeding.

Upper gastrointestinal bleeding (UGIB) is common, with an annual incidence of approximately 67 to 150 per 100,000, with estimated mortality rates between 6% and 15%. Many patients require hospital admission and ultimately endoscopic evaluation for diagnosis and treatment of the hemorrhage. It is standard practice to start patients with undifferentiated UGIB on acid suppression therapy with an intravenous proton-pump inhibitor (PPI) in the emergency department prior to admission or endoscopy. This practice is based on data that the most common cause of UGIB is peptic ulcer disease. Intravenous PPI may create optimal conditions for clotting over arteries at ulcer bases, as neutralization of gastric acid leads to stabilization of blood clots.