Inadequate use of proton-pump inhibitors in patients with liver cirrhosis.

Abstract:

OBJECTIVES:Patients with liver cirrhosis have a high prevalence of gastrointestinal symptoms. The use of antiacid therapy (AAT) in these patients is unexplored. We aimed to assess the use of AAT in cirrhotic patients. METHODS:A total of 128 consecutive cirrhotic patients were evaluated for the use of and indications for acid-suppressive agents. Upper endoscopy findings and concomitant medications were registered. A validated questionnaire was used to measure the gastrointestinal symptom burden. Adequate indications for AAT were those strongly supported by the medical literature. RESULTS:Forty percent (n=51) of patients with cirrhosis were on AAT. Thirty-seven percent (n=19) of these had adequate and 63% (n=32) inadequate indications for AAT. The major inadequate indication was previous variceal bleeding (34%). Patients with inadequate indications for AAT had increased severity of symptoms of indigestion compared with patients without AAT (P<0.05). Multivariate analysis revealed that inadequate use of AAT was independently related only to previous variceal bleeding and the number of concomitant medications. CONCLUSION:AAT is used by a large proportion of patients with cirrhosis. In the majority, therapy is based on inadequate indications, mainly continuous long-term therapy after previous variceal bleeding. Patients with an inadequate indication for acid-suppressive medications have increased severity of symptoms of indigestion, indicating that gastrointestinal symptoms might be a factor contributing to proton-pump inhibitor consumption in these patients.

authors

Kalaitzakis E,Björnsson E

doi

10.1097/MEG.0b013e3282f4aa01

subject

Has Abstract

pub_date

2008-06-01 00:00:00

pages

512-8

issue

6

eissn

0954-691X

issn

1473-5687

pii

00042737-200806000-00008

journal_volume

20

pub_type

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