Gli antisecretivi nell'emorragia del tratto gastroenterico superiore

Aim of the paper was to review what is known about the effectiveness of antisecretory therapy for acute upper gastrointestinal bleeding. Upper gastrointestinal endoscopy has become the standard of care in such cases, as it reliably establishes the etiology of bleeding and allows for active hemostatic therapy for any lesion identified. Although endoscopic hemostasis is successful in more than 90% of cases of bleeding peptic ulcer, rebleeding occurs within 72 hr in up to 25% of cases such that rebleeding following successful hemostasis has become the major unsolved problem in the management of acute upper gastrointestinal bleeding. The available data are consistent with the notion that reliable maintenance of the intragastric pH at ≥ 6 after endoscopic hemostasis is associated with the lowest rebleeding rates. H ₂- receptor antagonists are scarcely effective for achieving this goal.