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Upper gastrointestinal (GI) bleeding is a common reason for emergency hospital admission. Proton pump inhibitors (PPIs) reduce gastric acid production and are used to manage upper GI bleeding. However, there is conflicting evidence regarding the clinical efficacy of proton pump inhibitors initiated before endoscopy in people with upper gastrointestinal bleeding. To assess the effects of PPI treatment initiated prior to endoscopy in people with acute upper GI bleeding. We searched the CENTRAL, MEDLINE, Embase and CINAHL databases and majo