Upper GI Bleeding-Post-Endoscopy PPI — ESEGH MCQ

Instant feedback + full explanation. One question, done properly.

EasyGastroenterologyUpper GI Bleeding-Post-Endoscopy PPIESEGH

A 34‑year‑old man presents with hematemesis. Endoscopy demonstrates a peptic ulcer with high‑risk stigmata (Forrest Ia–IIa), which is treated successfully with endoscopic hemostasis. What is the recommended PPI regimen for the first 72 hours after endoscopic treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Intravenous omeprazole 80 mg bolus followed by continuous infusion of 8 mg/hour

Current UK and European guidance recommends a high‑dose intravenous proton pump inhibitor regimen after endoscopic hemostasis of high‑risk peptic ulcers. The ESGE Guideline (strong recommendation, high‑quality evidence) specifies an initial 80 mg IV bolus followed by continuous infusion at 8 mg/hour for 72 hours. This is endorsed in BSG guidance, which notes that infusion regimens are appropriate. Oral once‑daily PPI (A) is inadequate for high‑risk stigmata; IV H₂‑blockers (C) are less effective; withholding acid suppression (D) or using sucralfate alone (E) lacks evidence for rebleeding prevention.

Reference: ESGE Guideline 'Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage' (2015); BSG guideline on peptic ulcer bleeding (2019), https://www.esge.com/diagnosis-and-management-of-nonvariceal-upper-gastrointestinal-hemorrhage