Overview
The goal of this clinical trial is to test if metoclopramide can improve effectiveness of endoscopic intervention in upper gastrointestinal (GI) bleeds. The main questions the investigators hope to answer is
Does metoclopramide lessen the need for repeat endoscopy, interventional radiology intervention or surgery in cases of upper GI bleed?
Does metoclopramide improve visibility of the GI walls in cases of upper GI bleed?
Description
The purpose of the study is to see if giving metoclopramide prior to an endoscopy in cases of upper GI bleed can decrease the need for repeat endoscopy due to poor visibility. Metoclopramide stimulates stomach and intestine activity. It is used to treat nausea, vomiting and slow gut movement. The investigators are testing if metoclopramide's effect on stimulating stomach activity can lead to more effective emptying of blood from the stomach and upper intestines in upper GI bleeding so physicians conducting endoscopies can easily see the stomach and intestinal wall and treat the source of bleeding.
Eligibility
Inclusion Criteria:
- Age 18 and above
- Admitted to ER or inpatient services at Javon Bea Hospital MercyHealth Riverside
- Present with upper GI bleeding defined as fresh and bright red hematemesis, coffee-ground hematemesis or melena
- Plan to undergo EGD within 24 hours since admission or since first symptoms
- Calculated Glasgow-Blatchford score ≥ 2
Exclusion Criteria:
- Failure to obtain informed consent
- Known allergy to metoclopramide
- Concurrent use of medications known to cause tardive dyskinesia (TD)/extrapyramidal symptoms/neuroleptic malignant syndrome
- History of TD or dystonic reaction to metoclopramide
- Pheochromocytoma, catecholamine-releasing paragangliomas
- Parkinson's Disease
- Epilepsy
- Pregnancy or lactation
- Previous gastrectomy