Document Detail


PPIs are not associated with a lower incidence of portal-hypertension-related bleeding in cirrhosis.
MedLine Citation:
PMID:  21155009     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To determine if proton pump inhibitor use in cirrhotic patients with endoscopic findings of portal hypertension is associated with a lower frequency of gastrointestinal bleeding.
METHODS: Patients with cirrhosis and endoscopic findings related to portal hypertension, receiving or not receiving proton pump inhibitor (PPI) therapy, were included retrospectively. We assigned patients to two groups: group 1 patients underwent PPI therapy and group 2 patients did not undergo PPI therapy.
RESULTS: One hundred and five patients with a median age of 58 (26-87) years were included, 57 (54.3%) of which were women. Esophageal varices were found in 82 (78%) patients, portal hypertensive gastropathy in 72 (68.6%) patients, and gastric varices in 15 (14.3%) patients. PPI therapy was used in 45.5% of patients (n = 48). Seventeen (16.1%) patients presented with upper gastrointestinal bleeding; in 14/17 (82.3%) patients, bleeding was secondary to esophageal varices, and in 3/17 patients bleeding was attributed to portal hypertensive gastropathy. Bleeding related to portal hypertension according to PPI therapy occurred in 18.7% (n = 9) of group 1 and in 14% (n = 8) of group 2 (odds ratio: 0.83, 95% confidence interval: 0.5-1.3, P = 0.51).
CONCLUSION: Portal hypertension bleeding is not associated with PPI use. These findings do not support the prescription of PPIs in patients with chronic liver disease with no currently accepted indication.
Authors:
Mauricio Garcia-Saenz-de-Sicilia; Francisco Sanchez-Avila; Norberto-C Chavez-Tapia; Gustavo Lopez-Arce; Sandra Garcia-Osogobio; Roberto Ruiz-Cordero; Felix-I Tellez-Avila
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  16     ISSN:  2219-2840     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-14     Completed Date:  2011-03-14     Revised Date:  2014-05-20    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  5869-73     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Gastroesophageal Reflux / drug therapy
Gastrointestinal Hemorrhage / drug therapy*,  etiology*
Humans
Hypertension, Portal / complications*
Liver Cirrhosis / complications*
Middle Aged
Proton Pump Inhibitors / adverse effects*,  therapeutic use
Retrospective Studies
Risk Factors
Chemical
Reg. No./Substance:
0/Proton Pump Inhibitors
Comments/Corrections

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