Drugs used prior to endoscopy
The use of proton pump inhibitors (PPI) prior to
endoscopy has shown no benefit in important
outcomes such as mortality, re-bleeding or need
for surgery, so it is not recommended. However,
intravenous PPI is routinely administered
prior to endoscopy in units that lack an out of
hours GI bleed rota. In patients with suspected
variceal haemorrhage, terlipressin has been
recommended as the treatment of choice prior
to endoscopy (Freeman et al, 1989; Ioannou
et al, 2003). Patients with a suspected variceal
bleed should also receive prophylactic antibiotic
therapy, as this significantly reduces the mortality
rate