Topical Prostaglandin E2 in the Treatment of Acute Upper Gastrointestinal Tract Hemorrhage: A Prospective, Randomized, Double-blind Study

We performed a prospective, randomized, double-blind study to assess the efficacy of topical prostaglandin E₂ (PGE₂) in altering the course of patients with severe upper gastrointestinal tract hemorrhage. Forty-four patients with life-threatening, endoscopically proven hemorrhage were randomly allocated to receive either PGE₂ or placebo for seven days. Severity of mucosal injury, determined by endoscopy, was scored both before and after completion of treatment. There were no significant differences between groups in either transfusion requirements or successful outcomes. However, the PGE₂ group had significantly improved endoscopic injury scores while the placebo group did not. Therefore, topical PGE₂ does not control acute hemorrhage from established upper gastrointestinal tract lesions, but it does result in an accelerated healing of established lesions.