Evaluation of the effectiveness of controlled pH in management of massive upper gastrointestinal bleeding

Twenty-five patients with massive upper gastrointestinal hemorrhage have been treated by control of the intragastric pH at 7.0 with antacids. In twenty-three of the twenty-five patients, bleeding stopped. The two treatment failures included one patient in whom the pH could not be raised above 4.5 despite massive instillations of antacid; the other failure occurred in a patient who had had thrombolytic therapy and extensive small bowel resection for gangrene.