In this episode, we dive into the evolving evidence behind proton pump inhibitors (PPIs) in the management of nonvariceal upper gastrointestinal bleeding. While PPIs have long been considered standard early therapy, emerging data challenge whether starting treatment before endoscopy meaningfully improves major clinical outcomes such as mortality, surgery, or overall rebleeding rates. We explore how current evidence suggests the clearest benefit may be in patients with confirmed peptic ulcer bleeding, where PPIs can help reduce recurrent bleeding after endoscopic therapy. The episode also examines the growing shift away from continuous IV infusions toward intermittent dosing strategies, which appear similarly effective while potentially reducing cost and resource use. Join us as we unpack how evidence-based medicine is reshaping long-standing practices in emergency gastrointestinal care.