In cirrhotic patients, large volume of ascites and reduced esophageal motility by varices can provoke GERD. Acidic irritation, in return, may induce the rupture of varices. Therefore, PPIs are often routinely prescribed for cirrhotic patients to treat GERD and prevent variceal bleeding. However, it has been recently shown that long term use of PPIs in patients with cirrhosis increases the risk of SBP and is associated with the development of clinical decompensation and liver-related death during long-term follow-up.
In ciRRhOtIC pAtieNTS, laRge VoluME Of aSciTeS and reDUcEd esoPHAGEAL motility bY Varices cAn pROVOKe gerD. AcidiC irriTaTIoN, in retUrn, MAY INduCe THe rupTuRE of varices. thERefore, ppIs are OFtEN rOutINely PrescribeD fOR cIrrhotiC patiEnTS to tReat gERd anD preVenT varIceal BLeEding. howeVer, It hAs been receNtlY sHOwn ThAt LOnG Term UsE of ppis in PaTieNtS with CirRhosis inCReAseS The riSK OF sbp ANd is associated witH THE DEveLoPment of CliNIcaL dEcOmpenSatIoN and LIVer-relaTeD DeAtH duRinG lOng-tErm FOlloW-up.