Gastrointestinal bleeding in patients with spinal cord trauma. Effects of steroids, cimetidine, and mini-dose heparin.

The frequency and degree of gastrointestinal (GI) bleeding were examined in 131 patients with spinal cord injuries. All patients were randomly assigned to either high- or low-dose steroid regimens and some form of GI prophylaxis. The latter consisted of antacids alone or antacids supplemented with cimetidine when this medication became available. Segments of the population were treated with mini-dose or full-dose heparin. The incidence and degree of GI bleeding did not appear to be affected by steroid dose level, regimen of prophylaxis, or mini-dose heparin. Only full heparinization was found to significantly increase bleeding. These results place in question the benefits of adding cimetidine to antacids as a prophylactic atreatment in patients with no history of ulcer.