MedWire News: Long-term treatment with stomach acid-suppressing drugs called proton pump inhibitors significantly reduces the risk of recurrent bleeding in patients with stomach ulcers and other upper gastrointestinal problems, research shows.

In patients with bleeding peptic ulcers, short-term treatment with proton pump inhibitors plays an important role in helping to prevent re-bleeding immediately after surgical treatment. The drugs help by preventing stomach acid from 'destabilising' the newly formed blood clot, explain Dr Luis Alberto García Rodríguez and Dr E Masso Gonzalez from the Spanish Centre for Pharmacoepidemiological Research in Madrid.

However, they add that up to 40% of patients who survive an episode of upper gastrointestinal bleeding experience a recurrence of bleeding within 1 year.

To investigate whether long-term treatment with proton pump inhibitors reduces this risk, the team studied data on 1287 patients, aged between 40 and 84 years, with peptic ulcers or gastritis who were treated for an episode of gastrointestinal bleeding.

In total, 67 of these patients experienced a recurrent episode of bleeding within 3 years of treatment.

After accounting for age, gender and other factors, analysis revealed that patients taking proton pump inhibitors were around 50% less likely to experience a recurrence of bleeding during the monitoring period than those who were not taking these stomach acid-suppressing drugs.

Proton pump inhibitors even appeared to reduce the risk of upper gastrointestinal re-bleeding in patients who were taking 'blood-thinning' drugs such as warfarin for co-occurring cardiovascular conditions.

"Irrespective of the individual background risk, proton pump inhibitor use was associated with a reduction by half in the risk of recurrent upper gastrointestinal bleeding," say the researchers. "The reduction in risk of recurrence was particularly apparent with use of proton pump inhibitors for longer than 1 year."

They conclude: "Our results thus support the long-term use of proton pump inhibitors in the secondary prevention of upper gastrointestinal bleeding."

The research is published in the journal Alimentary Pharmacology and Therapeutics.