Program Description

Regardless of the admitting diagnosis or concomitant disease, ulcer bleeding or rebleeding after admission to the hospital are common in an intensive care setting. Appropriate therapy requires a thorough understanding of the aims of acid suppression, somewhat similar to, but distinct from, those of acid suppression to prevent stress related mucosal disease (SRMD). While those at low risk for SRMD may be managed using oral acid suppressive and other drug therapies, more aggressive treatment strategies are needed for patients at high risk of bleeding. Those with recent or active bleeds from ulcers require more aggressive therapy and higher doses of drugs. Although pharmacotherapy may be associated with increased costs initially, much evidence suggests that these treatments decrease overall costs of health care by reducing hospital stay and needs for additional therapy, ultimately decreasing patient morbidity and mortality. This symposium will review the role of acid suppression in the management of ulcer bleeding and in the prevention of stress ulceration, and provide an analysis of the available treatment options in terms of efficacy and cost.