INFLUENCE OF PROTON PUMP INHIBITORS IN PATIENTS WITH LIVER CIRRHOSIS
Keywords:
proton pump inhibitors, liver cirrhosis, hepatic encephalopathy, Clostridium difficile infection, vitamin B12 deficiency, gut-liver axisAbstract
Proton pump inhibitors (PPIs) are widely used to manage gastroesophageal reflux disease (GERD) in patients with liver cirrhosis, yet their long-term impact on this vulnerable population remains unclear. The study aimed to assess the association between PPI use and adverse outcomes, including hepatic encephalopathy (HE), Clostridium difficile infection, and vitamin B12 deficiency in cirrhotic patients. Despite evidence linking PPI use to these complications, there remains a knowledge gap regarding the mechanisms involved and optimal management strategies.
In this retrospective cohort study, clinical data from 300 cirrhotic patients on PPI therapy and 100 controls were analyzed. The incidence of HE, infections, and nutrient deficiencies were compared between groups. Findings revealed a significantly higher rate of HE (45% vs. 25%), increased Clostridium difficile infections (12% vs. 5%), and lower B12 levels among PPI users compared to controls (p < 0.05).
The results indicate that prolonged PPI therapy may exacerbate cirrhosis-related complications through mechanisms involving gut microbiota disruption and nutrient malabsorption. These findings underscore the need for cautious use of PPIs in cirrhotic patients and suggest the importance of monitoring for adverse effects. Further research is necessary to understand the dose-response relationship and to develop guidelines that balance the benefits of acid suppression with potential risks in this population.
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