Canadian Journal of Gastroenterology and Hepatology

Canadian Journal of Gastroenterology and Hepatology / 2004 / Article

Canadian Gastroenterology Elsewhere | Open Access

Volume 18 |Article ID 742140 |

Sander Veldhuyzen van Zanten, "Cost-Effectiveness of Intravenous Proton Pump Inhibitors in High-Risk Bleeders", Canadian Journal of Gastroenterology and Hepatology, vol. 18, Article ID 742140, 2 pages, 2004.

Cost-Effectiveness of Intravenous Proton Pump Inhibitors in High-Risk Bleeders


There is unequivocal evidence that proton pump inhibitors (PPIs) are currently the most effective acid suppressive agents available. Intravenous (IV) formulations have been developed, although only IV pantoprazole is available in Canada. In patients presenting with serious upper gastrointestinal (GI) bleeding due to duodenal or gastric ulcers, it has always been believed that IV administration of acid-lowering agents would improve clinical outcomes. The reason behind this thinking is twofold. First, there is in vitro evidence that formed clots are more stable at or near neutral pH (1). Second, by administering the agent intravenously, suppression of acid production is achieved much more quickly, thereby promoting more rapid healing of the ulcer and reducing the risk of persistent or recurrent bleeding. Interestingly and surprisingly, however, the data for intravenous H2-blockers have been disappointing (2). This failure to demonstrate clinical benefit has never been fully explained.

Copyright © 2004 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

More related articles

 PDF Download Citation Citation
 Order printed copiesOrder

Related articles

We are committed to sharing findings related to COVID-19 as quickly as possible. We will be providing unlimited waivers of publication charges for accepted research articles as well as case reports and case series related to COVID-19. Review articles are excluded from this waiver policy. Sign up here as a reviewer to help fast-track new submissions.