Klebl, Frank H. and Schoelmerich, J. (2008) Future expectations in the prophylaxis of intestinal bleeding. BEST PRACTICE & RESEARCH IN CLINICAL GASTROENTEROLOGY, 22 (2). pp. 373-387. ISSN 1521-6918,
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Prophylaxis of gastrointestinal bleeding is attempted in widely varying situations. In NSAID-induced peptic ulcer, the advantage of selective cyclooxygenase 2 inhibitors with regard to gastrointestinal damage has yet to be translated into an advantage in overall morbidity. Strategies for primary and secondary prevention of variceal bleeding have been established. Therapy tailored to hepatic venous pressure gradient has the potential to achieve clinical relevance. Several methods have been developed to prevent postpolypectomy bleeding, but their optimal risk-tailored application has yet to be demonstrated. Although octreotide treatment seems to be beneficial in reducing the blood loss from angiodysplasias, controlled studies to determine its optimal use are awaited. Stress-ulcer prophylaxis is commonly applied in critically ill patients. Although data indicate that H-2-receptor antagonists and omeprazole are effective in preventing clinically significant bleeding, evidence for an advantage with respect to length of hospital or intensive-care-unit stay, as well as mortality, is still lacking. Since there is misuse of acid-suppressing drugs on regular wards, in-house guidelines may offer the potential for saving costs and reducing inappropriate prescription.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | NONSTEROIDAL ANTIINFLAMMATORY DRUGS; STRESS-ULCER PROPHYLAXIS; LOW-DOSE-ASPIRIN; ENDOSCOPIC VARICEAL LIGATION; CRITICALLY-ILL PATIENTS; REQUIRING MECHANICAL VENTILATION; ENDOLOOP-ASSISTED POLYPECTOMY; PORTAL-HYPERTENSION; RANDOMIZED-TRIAL; DOUBLE-BLIND; stress ulcer prophylaxis; bleeding prophylaxis; variceal bleeding; peptic ulcer bleeding; stress-related mucosal disease |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 11 Nov 2020 09:37 |
| Last Modified: | 11 Nov 2020 09:37 |
| URI: | https://pred.uni-regensburg.de/id/eprint/31547 |
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