Box 1. Summary of post-endoscopic intravenous PPI in peptic ulcer disease.

• PPIs are superior to H2RAs in reducing rebleeding and surgery in patients with bleeding peptic ulcers, but all cause mortality is not affected.

• Infusional IV, bolus IV and oral PPI, when given at the same dosage and intervals, are probably equipotent in raising intragastric pH. Infusional IV PPI likely achieves this fastest, although PPI plus antacid (e.g. sodium bicarbonate) would likely be even faster.

• Clinically, infusional IV PPI (80 mg IV bolus followed by 8 mg/h for 72 h), in combination with endoscopic hemostasis provides the lowest rebleeding rates in high-risk peptic ulcers.

• IV bolus and oral PPI may be as efficacious as infusional IV PPI, but more data is needed before this can be recommended.

PPIs, proton-pump inhibitors; H2RAs, H2-receptor antagonists; IV, intravenous.