Journal of AdvancedMedical and Dental Sciences Research

Background: Hemorrhage from stress-induced gastric lesions (stress ulcers) was a significant problem in many critically ill surgical patients in the 1960s who had sepsis and evidence of organ failure.' Hemorrhage from stress ulcers has been defined as gut failure in the multiple organ failure syndrome and continues to be associated with high mortality rates when it develops postoperatively. Objective: To develop practice guidelines for the regulation of gastrointestinal hemorrhage in adult cases with cirrhosis by administrating H2 blockers and Proton pump inhibitors. Methodology: 155 cases of upper gastrointestinal bleeding with cirrhosis were entailed in the study and randomized in to 2 groups. Group A administered with omeprazole 40 mg intravenously for every 12 hours and group B with 77 patients received 300 mg cimetidine intravenously every 6 hours and the outcomes were measured. Result: A total of 155 patients met the inclusion criteria and thus were recruited. There was no remarkable difference in the number of cases who required ventilation in the ICU units over and above 48 hours or those who had sepsis. In omeprazole group (78patients), mean baseline pH 2.7± 1.1 (increased to 5.6 ± 0.5 after drug administration); cimetidine group (77 patients), mean baseline pH 2.9 ± 0.8 (increased to 4.7 ± 1.0 after drug administration. The number of samples with a pH of 4 or lower was 7 (12.1%) of 78, and 31 (57.4%) of 77, in omeprazole and cimetidine respectively (p < 0.001) Keywords: Stress ulcer, medication prophylaxis, mortality, intravenous omeprazole, cimetidine, Cirrhosis, Upper gastrointestinal hemorrhage.