Background: The high mortality rate in patients with upper gastrointestinal
breeding appears to be particularly related to re-bleeding. The haemostati
c mechanisms that may influence the re-bleeding of ulcers are largely unkno
Aim: We studied and analysed fibrinolytic activity in breeding ulcer patien
ts and the effect of acid suppression on this activity.
Methods: Fibrinolytic activity was analysed in mucosal biopsies from 29 ble
eding gastroduodenal ulcer patients and six controls. We analysed revers of
D-Dimer, fibrin plate lysis area, plasminogen activator activity, plasmino
gen activator inhibitor activity, and plasmin antiplasmin complexes.
Results: Significantly more fibrinolytic activity was detected in biopsies
from patients with bleeding ulcers compared to controls. Moreover, in patie
nts with endoscopic stigmata of recent haemorrhage, mucosal fibrinolytic ac
tivity was higher compared to patients without stigmata of recent haemorrha
ge. In mucosal biopsies of patients that had used acid suppression before a
dmission, a decreased fibrinolytic activity was found compared to patients
without such therapy. This effect of acid suppression on fibrinolytic activ
ity was confirmed in nine patients before and after a 24-h ranitidine infus
Conclusions: Fibrinolytic activity is enhanced in patients with bleeding ga
stroduodenal ulcers. Acid suppressive therapy decreases this increased acti
vity, which may be one of the mechanisms explaining the potential beneficia
l effect of this therapy.