Drugs & Aging

, Volume 31, Issue 5, pp 349–361 | Cite as

Pharmacologic Options in the Management of Upper Gastrointestinal Bleeding: Focus on the Elderly

  • Moe Htet Kyaw
  • Francis Ka Leung Chan
Review Article


Despite the major advances in the treatment of peptic ulcer disease, its complication in the elderly has increased. This is because of the increasing use of non-steroidal anti-inflammatory drugs, and the high prevalence of Helicobacter pylori infection. The presentation of peptic ulcers in the elderly patients can be subtle, and late presentation with upper gastrointestinal bleeding of peptic ulcers is not uncommon in the elderly population. The aim of this article is to review the current treatment options for upper gastrointestinal bleeding, and to discuss the place of drug therapy in both the acute and ongoing management of individual patients. Its focus will be on the benefits and risks of each option in the elderly. There is significant evidence to suggest that anti-secretory medications are useful in the treatment of peptic ulcers and associated complications in the elderly. Although a large number of studies have reported potential adverse effects of proton pump inhibitors, this evidence comes from retrospective observational studies, and such reports should be regarded with caution, and randomized controlled studies are required to confirm or refute these results. Nonetheless, it will be important to practice the appropriate use of acid suppression therapy, and identify which patients will gain maximum benefit from proton pump inhibitor therapy.


Peptic Ulcer Omeprazole Celecoxib Pylorus Infection Misoprostol 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Both Prof. Chan and Dr. Kyaw declare that they have no significant competing financial, professional, or personal interests that might have influenced the performance or presentation of the work described in this manuscript.


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  1. 1.Institute of Digestive DiseasesThe Chinese University of Hong Kong, Prince of Wales HospitalShatinHong Kong

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