Effects of proton pump inhibitor on gastroesophageal varices in patients with cirrhosis: A randomized controlled trial from China

AimsProton pump inhibitors (PPI) are widely used for gastroesophageal varices in patients with cirrhosis after endoscopic therapy, although the effect of PPI on these patients remains controversial. This study aimed to evaluate the effect of PPI on gastroesophageal varices in patients with cirrhosis after endoscopic therapy, including variceal bleeding and adverse events.MethodsCirrhotic patients with endoscopically confirmed gastroesophageal varices were enrolled in this study between May 2017 and June 2019. Eligible patients were randomized into two groups: one group received PPI for 14 days and the other group did not receive PPI treatment (n = 53 in each group). All patients were followed for 8 weeks.ResultsDuring the follow-up period, three patients (5.66%) in the PPI group experienced variceal bleeding on days 9, 16, and 25 after endoscopic therapy, including two patients with acute bleeding and one with primary prophylaxis. In the non-PPI group, three patients (5.66%) experienced variceal bleeding on days 7, 42, and 56 after endoscopic therapy, including one patient with acute bleeding and two with secondary prophylaxis (p = 0.990). The incidence of adverse events was similar between the two groups (37.74% vs. 28.30%, p = 0.30).ConclusionsPPI did not appear to reduce variceal bleeding and adverse events in patients with cirrhosis after endoscopic therapy. Proton pump inhibitors (PPI) are widely used after endoscopic therapy for gastroesophageal varices in patients with cirrhosis, though their effectiveness is debatable. According to this study, PPI use is not associated with a decreased risk of variceal bleeding and adverse events in such patients.Key points image Significant findings of the studyProton pump inhibitors (PPI) are widely used after endoscopic therapy for gastroesophageal varices in patients with cirrhosis, though their effectiveness is debatable. According to this study, PPI use is not associated with a decreased risk of variceal bleeding and adverse events in such patients.What this study adds?Unnecessary PPI administration is not beneficial in cirrhotic patients with gastroesophageal varices and requires more attention from physicians.