Somatostatin and ranitidine in the treatment of non-variceal upper gastrointestinal bleeding:: A prospective, randomized, double-blind, controlled study

Background/Aims: The aim of this study was to compare the efficacy of somatostatin vs. ranitidine in controlling acute non-variceal gastrointestinal bleeding. Methodology: A total of 48 patients with acute upper gastrointestinal bleeding due to duodenal or gastric ulcer were divided into 2 groups. Group I consisted of 15 patients with Forrest IB and Group II consisted of 30 patients with Forrest II. Two regimens were randomly allocated to all patients within half an hour after the endoscopic procedure: 1) somatostatin-UCB 250mcg IV bolus followed by continuous IV infusion at a rate of 6mg/d for 72h, or 2) ranitidine 300mg/d by continuous IV infusion for 72h. Results: In Group I, although mean blood transfusion requirements (no. of units) were lower in patients treated with somatostatin than in those treated with ranitidine,this was not statistically significant (mean+/-SD: 2.56+/-3.05 vs. 5.17+/-4.96, respectively; P>0.05); the time of bleeding stop was shorter in the somatostatin group than in the ranitidine group (mean+/-SD: 3.24+/-2.45 vs. 11.25+/-11.63, respectively; P=0.0383). The rebleeding and the mortality rates did not differ between the treatment groups in both Group I and Group II. Conclusions: Somatostatin is more effective than ranitidine in controlling acute non-variceal gastrointestinal bleeding in patients with Forrest IB bleeding activity. Somatostatin has no additional benefit in those with Forrest II bleeding activity.