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The effect of the use of proton pump inhibitors (PPI) on complications in patients with cirrhosis

Atasoy H, Levent A

BMC gastroenterology, 2026

220 participants

Abstract

BACKGROUND/AIM: In our study, we aimed to investigate the effect of PPI use on peritonitis, and hepatic encephalopathy in patients with liver cirrhosis. MATERIALS AND METHODS: Our study was conducted on 220 patients. Patients with cirrhosis were divided into two groups PPI users and non-users. After the patients who did not use PPIs in their records were informed that they should not use PPIs in the future, both groups were followed up for three more years. 129 (58.6%) of the patients were PPI users and 91 (41.4%) of the patients were not PPI users. At the end of three years, these two groups were compared in terms of peritonitis. and encephalopathy. RESULTS: The presence of encephalopathy was compared with PPI use status. Encephalopathy was present in 20 (16.2%) of PPI users, while 12 (13.2%) of non-PPI users had encephalopathy. No significant difference was found between the groups (p=0.230). When the presence of peritonitis in the patients was analyzed, peritonitis was found in 30 (23.7%) of the patients using PPIs, while 16 (17.6%) of the patients not using PPIs had peritonitis. There was no statistically significant difference between the groups (p=0.103). CONCLUSION: In our study, there was no statistically significant association between PPI use, peritonitis, and encephalopathy in patients with cirrhosis. It may be possible that this association may emerge in patients with decompensated cirrhosis and longer follow-up.

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 220 participants or records.

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