Treatment for bleeding duodenal ulcer includes which of the following?

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In a bleeding duodenal ulcer, rapid and sustained suppression of gastric acid is crucial because a higher intragastric pH helps stabilize the forming clot and reduces the risk of ongoing bleeding. An intravenous proton pump inhibitor provides that rapid, reliable acid suppression during an acute bleed, which improves hemostasis and lowers rebleeding risk. Among the options, the IV esomeprazole drip offers this needed effect, delivering continuous acid suppression directly into the circulation for quick action.

Oral PPI therapy is less reliable in the acute bleeding setting because absorption can be impaired and onset is slower, delaying acid suppression when it's most needed. An IV H2 receptor blocker can reduce acid somewhat but is generally less effective than IV PPI therapy in preventing rebleeding. Antacid therapy only neutralizes some acid temporarily and does not provide the sustained acid suppression that improves outcomes in a bleeding peptic ulcer.

In summary, the best approach here is IV proton pump inhibitor therapy to achieve rapid, sustained acid suppression and support hemostasis, which is why the IV esomeprazole option is preferred among the choices.