Omeprazole, a PPI, therapy causes malabsorption of cyanocobalamin (vitamin B12)

OBJECTIVE: To evaluate protein-bound cyanocobalamin (vitamin B12) absorption before and after omeprazole (Prilosec) therapy in healthy male volunteers. DESIGN: Clinical trial in which each volunteer served as his own control. SETTING: Outpatient department of a university medical center. PARTICIPANTS: Ten healthy, male volunteers 22 to 50 years old. INTERVENTION: Each participant had a modified Schilling test (protein-bound cyanocobalamin) and a gastric analysis, as well as measurements of serum vitamin B12, gastrin, and folate levels. Five patients were then randomly assigned to take either 20 mg or 40 mg of omeprazole daily. After 2 weeks of omeprazole therapy, these tests were

High-Dose vs Non–High-Dose Proton Pump Inhibitors After Endoscopic Treatment in Patients With Bleeding Peptic Ulcer

A Systematic Review and Meta-analysis of Randomized Controlled Trials Background High-dose proton pump inhibitors (PPIs) (80-mgbolus, followed by 8-mg/h continuous infusion for 72 hours)have been widely studied and used. However, to date no concrete evidence has shown that high-dose PPIs are more effective than non–high-dose PPIs. Methods We performed a literature search for randomized controlled trials that compared the use of high-dose PPIs vsnon–high-dose PPIs in patients with bleeding peptic ulcerand determined their effects on re-bleeding, surgical intervention,and mortality. Outcomes data were combined in a meta-analysis and were reported as odds ratios (ORs) with 95% confidence intervals(CIs). Results A total of 1157 patients