Bleeding peptic ulcers remain a major cause of non-variceal upper gastrointestinal hemorrhage, and optimizing post-endoscopic pharmacologic therapy is essential to reducing early rebleeding and improving clinical outcomes. This study evaluated the therapeutic effectiveness of high-dose versus low-dose omeprazole following endoscopic hemostasis. This retrospective observational study included patients with endoscopically confirmed bleeding peptic ulcers treated between August 2022 and August 2025. Patients received either high-dose omeprazole (80-mg intravenous loading dose followed by continuous infusion at 4 mg/h) or low-dose omeprazole (40 mg intravenously once daily) after endoscopic hemostasis. Hemoglobin, hematocrit, rebleeding rates, clinical recovery parameters, and adverse events were collected. Participants were followed for 30 days to evaluate delayed rebleeding. Continuous variables were analyzed using independent-samples t tests, and categorical variables using chi-square tests. A total of 119 patients were included (high-dose: n = 58; low-dose: n = 61). High-dose omeprazole significantly reduced rebleeding at 72 hours (6.9% vs 21.3%, P = .025) and 30 days (10.3% vs 29.5%, P = .009). Greater increases in hemoglobin and hematocrit, lower transfusion volume, faster cessation of bleeding, earlier hemodynamic stabilization, and shorter hospitalization were also observed (all P < .001). Adverse event rates were comparable between groups. High-dose omeprazole combined with endoscopic hemostasis enhances hemostatic stability, accelerates clinical recovery, and reduces short-term rebleeding without increasing treatment-related adverse events.
Fan et al. (Fri,) studied this question.