Evidence map›Paper›PMID 40611560›Full record

ArticleClinical endoscopy2025

Pre-endoscopy erythromycin versus metoclopramide for upper gastrointestinal bleeding: a systematic review and network meta-analysis.

Ravi Teja Pasam, Kanwal Bains, Srilekha Chava, Babu P Mohan

Abstract read
In one paragraph

Article in Clinical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Endoscopic Treatment of Upper Gastrointestinal Bleeding.The Korean journal of helicobacter and upper gastrointestinal research · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Ravi Teja PasamDepartment of Hospital Medicine, Wentworth-Douglass Hospital, Dover, NH, USA.
Kanwal BainsDepartment of Inpatient Medicine, University of Arizona, Tucson, AZ, USA.
Srilekha ChavaIndependent Researcher, Portsmouth, NH, USA.
Babu P MohanOrlando Gastroenterology, University of Central Florida School of Medicine, Orlando, FL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGiven the limited head-to-head trials comparing the outcomes of pre-endoscopy erythromycin and metoclopramide for upper gastrointestinal bleeding (UGIB), a network meta-analysis (NMA) and component NMA were conducted.

methodsA comprehensive review of the Medline, Embase, and Cochrane databases was conducted for randomized controlled trials comparing pre-endoscopy erythromycin or metoclopramide for UGIB with or without gastric lavage (GL) to placebo and/or GL. The primary outcome was the adequate visualization of the mucosa. The secondary outcomes were endoscopy visualization score, endoscopy duration, diagnosis established at initial endoscopy, second-look endoscopy, blood transfusions, mortality, and duration of hospitalization.

resultsA total of 16 studies (1,447 patients) were included. No significant differences were observed between erythromycin and metoclopramide in all the outcomes, but erythromycin had significantly better outcomes than the control group in terms of endoscopic visualization score (standardized mean difference, 0.58; 95% confidence interval [CI], 0.26-0.91), adequate mucosal visualization (risk ratio, 1.55; 95% CI, 1.18-2.04), second-look endoscopy, transfusion requirements, and duration of hospitalization. Component network meta-analysis revealed that erythromycin, but not metoclopramide or GL, provided significantly better endoscopic visualization than the placebo.

conclusionsErythromycin should be considered before UGIB endoscopy. The current data do not support the use of metoclopramide or GL.

Indexed as

Endoscopic visualizationErythromycinMetoclopramideUpper gastrointestinal bleeding

Identifiers

PMID40611560
PMCPMC12933551

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.