Effect of Famotidine After Endoscopic Treatment on Bleeding Peptic Ulcers

Effect of Famotidine After Endoscopic Treatment on Bleeding Peptic Ulcers Tomoari Kamada, Jiro Hata, Hiroaki Kusunoki, Yoshinori Fujimura, Tatsuro Tanimoto, Soichiro Kido, Hiroshige Hamada, Ken Haruma Background and Aim: Peptic ulcers are the most common cause of upper gastrointestinal bleeding. The aim of our study was to investigate the effect of acid suppressive therapy after endoscopic treatment on bleeding peptic ulcer diseases. Patients and Methods: The 398 patients with bleeding peptic ulcers were divided into two groups those receiving drip infusion of PPI (40 mg/day) (n Z 165, 116 men, 49 women, mean age 59.8 yrs) and those receiving infusion of famotidine (40 mg/day) (n Z 233, 188 men, 45 women, mean age 61.5 yrs) after initial endoscopic treatment. The rate of recurrent bleeding, mortality, fasting duration, hospital stay, the rate and volume of blood transfusion were evaluated between the two groups in our study. Results: The rate of re-bleeding was 7.8% in the famotidine group and 7.2% in the PPI group, no significant differences were found. The mean hospital stay for the PPI group was significantly shorter than that for the famotidine group (PPI group 18.3 day vs famotidine group 21.4 day, p ! 0.05). Also, mortality, fasting duration, the rate and volume of blood transfusion were no statistically significant differences between the two groups. Conclusion: Our study demonstrated that the infusion of famotidine after endoscopic treatment is an effective drug for bleeding peptic ulcer diseases. M1347 Impact of Change in Upper Gastrointestinal Endoscope Findings in Japan Takashi Kawai, Kohei Kawakami, Kazuo Takei, Takashi Okamoto, Naomi Uemura Background: H. pylori infection rate in Japan has been reported to be high, but recently it is decreasing rapidly. H.pylori infection has also been associated with gastritis, gastric polyp, peptic ulcers, and gastric cancer. We examined the H. pylori infection rate and correlation of H.pylori infection with upper gastrointestinal endoscope (UGIE) finding. Method: Subject were 419 patients who received UGIE and examined serum IgG H.pylori antibody for health check from August 2003 to April 2004. Mean ages were 39.2 ,} 8.3 (22-58 age). We investigated UGIE findings reference to atrophic gastritis (mild, moderate, severe), reflex esophagitis (RE), gastric fundic polyp (FP), gastric hyperplastic polyp (HP), Gastric kammroetung (GK), nodular gastritis (NG), gastric ulcer (GU), duodenal ulcer (DU). Result: Total H. pylori infection rate was 33.7% (141/419). Infection rates were 15.7% in age 20-29, 28.0% in age 30-39, 34.3% in age 40-49 and 69.6% in age 50-59. Rates of mild, moderate, and severe of atrophic gastritis were 96.2%, 3.2% and 0% respectively in H. pylori-negative patients. On the other hand, rates of mild, moderate, and severe of atrophic gastritis were 26.2%, 50.4% and 23.4% respectively in H. pylori-positive patients. Rates of UGIE findings were 25.8% in RE, 39.9% in GK, 8.6% in FP, 0% in HP, 0% in NG, 1.1% in GU, 1.4% in DU in H.pylorinegative patients. Rates of UGIE findings were 16.3% in RE, 5.0% in GK, 0.7% in FP, 4.3% in HP, 4.3% in NG, 13.4% in GU, 21.9% in DU in H.pylori-positive patients. Conclusion: H. pylori infection rate decreased drastically compared to a report by Asaka et al 1) (infection rate were 25% in age 20-29, 43% in age 30-39, 78% in age 40-49). There were significant differences in UGIE findings between H. pylori-negative and H. pylori-positive. In the future it is possible that UGIE findings in Japan will resemble those in Western countries, because of expectation of more decrease in H. pylori infection rate in Japan. 1) Asaka M, Kimura T, Takeda H, et al. Gastroenterology 1992; 102: 760-766.