After Ulcer Haemostasis: Can High-Dose Oral PPI Replace Continuous IV Infusion?: JGH | October 2026

What Did the Study Find?

This trial randomized 124 patients with high-risk peptic-ulcer bleeding after successful endoscopic haemostasis to oral omeprazole 40 mg twice daily or continuous IV pantoprazole 8 mg/hour for 72 hours.

• Rebleeding within 72 hours was 1.6% with oral therapy vs 4.8% with IV infusion.
• At 30 days, rebleeding remained similar: 3.3% vs 4.8%.
• In the smaller subgroup undergoing intragastric pH monitoring, time with pH >6 was 56.3% vs 27.3%, respectively.
• The pH difference was not statistically significant, and fewer than half of patients underwent monitoring.
• Only four early rebleeding events occurred.
• Importantly, the trial was not designed to establish formal noninferiority.

Why Does It Matter?

Avoiding continuous infusion could simplify post-endoscopic management, reduce infusion-pump dependence and potentially lower healthcare costs.

GastroAGI Takeaway

High-dose oral PPI appears clinically credible after secure endoscopic haemostasis—but “similar observed outcomes” does not prove equivalence. This small RCT supports oral therapy as a potential alternative in appropriately selected patients, but is insufficient to justify universally abandoning guideline-supported high-dose PPI regimens after high-risk ulcer bleeding.