Prevention of upper gastrointestinal bleeding

Although there are exciting new techniques to treat acute episodes of gastrointestinal bleeding, prevention is certainly preferable. In this issue of the Journal, Jensen and his colleagues present evidence that long-term maintenance therapy with histamine H₂-receptor antagonists significantly reduces the incidence of recurrent bleeding in patients who have previously bled from a duodenal ulcer¹. Prophylactic therapy has drawbacks, however, including side effects and cost. Thus, there is increasing interest in identifying patients who are at special risk for bleeding so that the use of preventive therapy can be limited. The desire to find patients for whom prophylaxis.