Comparison of the effects of intravenous infusion of omeprazole and H2‐receptor antagonists on intragastric pH in bleeding duodenal ulcer patients

OBJECTIVE: To evaluate the effects of intravenous infusion of omeprazole and H2‐receptor antagonists on 24‐h intragastric pH levels in patients with bleeding duodenal ulcers. METHODS: Fifty patients with active bleeding duodenal ulcers were randomly assigned to receive one of four treatment regimens: 40 mg omeprazole by intravenous infusion every 12 h, 40 mg famotidine intravenously every 12 h, 50 mg ranitidine intravenously every 6 h, 200 mg cimetidine intravenously every 6 h. Intragastric pH values were monitored in each subject at the baseline level and continuously for 24 h after treatment. RESULTS: Only the omeprazole group produced mean and median intragastric pH values of above 6. The famotidine group had mean and median intragastric pH values above 4. In the other two groups, pH values were both below 4. The mean percentages of time that intragastric pH levels were < 4, < 5 and < 6 over the 24 h period in each of the treatment groups were found to increase in the following order (smallest percentage to largest percentage): omeprazole, famotidine, ranitidine and cimetidine. CONCLUSIONS: The effect of intravenous use of omeprazole in active duodenal ulcer bleeding is superior to that of H2‐receptor antagonists and the increase in intragastric pH is maintained for a longer period.