Endoscopic Hydrogen Peroxide Spray May Facilitate Localization of the Bleeding Site in Acute Upper Gastrointestinal Bleeding

Wu, Deng Chiang; Lu, Chia Ying; Su, Yu-Chung; Perng, Daw‐Shyong; Wang, W. M.; Liu, Ching-Hsun; Jan, Chang Ming

doi:10.1055/s-1999-13675

Cited by 28 publications

(15 citation statements)

References 18 publications

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“…In general, a 7.5% solution of hydrogen peroxide is an FDA approved high‐level disinfectant or disinfectant . Clinically, 3% hydrogen peroxide has been used for temporary hemostasis and to ensure clear visualization of bleeding sites . The 100 m m hydrogen peroxide used in this study corresponds to about a 0.3% concentration and is not harmful to human body.…”

Section: Discussionmentioning

confidence: 99%

Hydrogen Peroxide Enhances the Antibacterial Effect of Methylene Blue‐based Photodynamic Therapy on Biofilm‐forming Bacteria

Yang

Lee

Park

et al. 2018

Photochem & Photobiology

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Recently, increased attention has been focused on endoscopic disinfection after outbreaks of drug‐resistant infections associated with gastrointestinal endoscopy. The aims of this study were to investigate the bactericidal efficacy of methylene blue (MB)‐based photodynamic therapy (PDT) on Pseudomonas aeruginosa (P. aeruginosa), which is the major cause of drug‐resistant postendoscopy outbreak, and to assess the synergistic effects of hydrogen peroxide addition to MB‐based PDT on biofilms. In planktonic state of P. aeruginosa, the maximum decrease was 3 log10 and 5.5 log10 at 20 and 30 J cm−2, respectively, following MB‐based PDT. However, the maximum reduction of colony forming unit (CFU) was decreased by 2.5 log10 and 3 log10 irradiation on biofilms. The biofilm formation was significantly inhibited upon irradiation with MB‐based PDT. When the biofilm state of P. aeruginosa was treated with MB‐based PDT with hydrogen peroxide, the CFU was significantly decreased by 6 log10 after 20 J cm−2, by 7 log10 after 30 J cm−2 irradiation, suggesting significantly higher efficacy than MB‐based PDT alone. The implementation of the combination of hydrogen peroxide with MB‐based PDT through working channels might be appropriate for preventing early colonization and biofilm formation in the endoscope and postendoscopy outbreak.

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Section: Discussionmentioning

confidence: 99%

Hydrogen Peroxide Enhances the Antibacterial Effect of Methylene Blue‐based Photodynamic Therapy on Biofilm‐forming Bacteria

Yang

Lee

Park

et al. 2018

Photochem & Photobiology

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“…The grades according to this system were: grade “0” for no change, grade “1” for minimal clearance, grade “2” for good clearance, and grade “3” for excellent clearance [ 16 ]. During endoscopy, a visible vessel was defined as an elevated red, bluish, or pulsatile spot on the ulcer [ 17 ]. If clots were seen, the ulcer base was vigorously sprayed with 5-ml aliquots of 250 ml sterile water at room temperature mixed with 5 ml of simethicone using a 5Fr spray tip catheter attached to a 30-ml syringe and applying a constant pressure.…”

Section: Methodsmentioning

confidence: 99%

“…Recent studies have shown that the removal of adherent clots by mechanical methods (shaving or trimming) without disturbing the pedicle may facilitate endoscopic therapy [ 14 ]. More recently, 3% hydrogen peroxide (H 2 O 2 ) solution has been used in a few animal and small-sample human studies to clear the adherent blood clots to gain better visibility of the ulcer bases [ 15 – 17 ]. The rationale for using H 2 O 2 is that it oxidizes the hemoglobin thus rendering the pigmented blood clot translucent and helping in its dissolution [ 18 – 20 ].…”

Section: Introductionmentioning

confidence: 99%

Hydrogen Peroxide Improves the Visibility of Ulcer Bases in Acute Non-variceal Upper Gastrointestinal Bleeding: A Single-Center Prospective Study

et al. 2009

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Background Acute non-variceal upper gastrointestinal bleeding (ANVB) or hemorrhage (used interchangeably) is an emergency. Endoscopically applied hydrogen peroxide (H 2 O 2 ) has been shown to improve visualization of the ulcer base. Aims To test the hypothesis that ulcer base clot clearance with 3% H 2 O 2 improves the visualization of ANVB lesions compared to water alone.Methods In this single-center prospective study, 320 patients with ANVB were examined, of which 81 met the entry criteria for evaluation. All patients with ANVB underwent urgent endoscopy. Those with adherent clots on the ulcer base were sprayed with 250 ml of water, followed by up to 100 ml of 3% H 2 O 2 . The main outcome measurement was Kalloo's Visual Scores of the ulcer base before and after water and H 2 O 2 . Results Eighty-one patients with gastric ulcers (GU; 34) and duodenal ulcers (DU; 47) met the entry criteria. The mean improvement in grade from water to H 2 O 2 was 2.04 (95% confidence interval [CI] (1.86, 2.23)). The mean volume of H 2 O 2 used to clear clots was higher (70 ml) in patients who were negative for both Helicobacter pylori and non-steroidal anti-inflammatory drug (NSAID) use than in those who were positive for both (31 ml) (P = 0.00). More DU patients (72%) had visible vessels than GU patients (44%) (P = 0.01). Conclusions H 2 O 2 improved the visualization of ulcer bases in ANVB. A smaller volume of H 2 O 2 was required to clear clots in patients who used NSAIDs and had H. pylori infection. H 2 O 2 identified more DU vessels. The use of H 2 O 2 should be considered as a standard therapy in the management of clots in ANVB.

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“…These include therapy for meconium ileus and fecal impaction, radiological localization of gastrointestinal hemorrhage and the demonstration of rectovaginal fistulae (1)(2)(3)(4)(5). While these techniques have been all but abandoned, more recently Wu et al (6) and Kalloo et al (7) both reported using 3% hydrogen peroxide in visualization of acute upper gastrointestinal bleeding. Finally, hydrogen peroxide has also been used widely as an endoscopic disinfectant.…”

Section: Rectite Causée Par Un Lavement Au Peroxyde D'hydrogène Et LImentioning

confidence: 99%

Waiting-List Induced Proctitis: The Hydrogen Peroxide Enema

Gan

Price

2003

Canadian Journal of Gastroenterology

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Hydrogen peroxide is a widely available disinfectant that has been reported to cause colitis. We report a case of a 67-year-old man who presented with an acute proctitis caused by a self-inflicted 3% hydrogen peroxide enema. The patient's intention was to cure himself of a recently diagnosed prostate cancer, because the waiting list for oncological consultation was deemed too long. The pathogenesis of hydrogen peroxide mucosal injury and a review of the literature is discussed.

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Endoscopic Hydrogen Peroxide Spray May Facilitate Localization of the Bleeding Site in Acute Upper Gastrointestinal Bleeding

Cited by 28 publications

References 18 publications

Hydrogen Peroxide Enhances the Antibacterial Effect of Methylene Blue‐based Photodynamic Therapy on Biofilm‐forming Bacteria

Hydrogen Peroxide Enhances the Antibacterial Effect of Methylene Blue‐based Photodynamic Therapy on Biofilm‐forming Bacteria

Hydrogen Peroxide Improves the Visibility of Ulcer Bases in Acute Non-variceal Upper Gastrointestinal Bleeding: A Single-Center Prospective Study

Waiting-List Induced Proctitis: The Hydrogen Peroxide Enema

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