A Literature Review: Adjunctive Use of Proton Pump Inhibitors to Variceal Band Ligation in Cirrhotic Patients
Issue: 2023 - Volume 6 [Issue 1]
Samar Mohamed Osman Ahmed Musa *
University of Khartoum, Saudi Arabia and Department of Clinical Pharmacy, University of Gezira, Saudi Arabia.
Moawia El Balal Mohamed
Faculty of Medicine, University of Gezira, Saudi Arabia.
*Author to whom correspondence should be addressed.
Introduction: This review focuses on the effect of Proton pump inhibitors (PPIs), acid-suppressive agents, combined with ligation to manage rebleeding ulcers in cirrhotic patients.
Methods: Data reviewed during approximately the last 20 years combining different studies concerning the use of antiacids in Variceal Cirrhotic Patients.
Result: Data showed different results, with most supporting the role of PPIs in this field.
Conclusion: PPIs used as adjunctive to EVL in cirrhotic patients for either prophylaxis or treatment of bleeding ulcers following ligation showed successful results and a good impact on general health and should be tried on those patients to improve their care.
Keywords: Acid suppression, ligation ulcer, PPI, varies
How to Cite
Zhu J, Qi X, H Yu, C Su, X Guo, Acid suppression in patients treated with endoscopic therapy for the management of gastroesophageal varices: A systematic review and meta-analysis, Expert Rev Gastroenterol Hepatol. 2018;12:617–624.
Garcia-Pagán JC, Bosch J. Endoscopic band ligation in the treatment of portal hypertension, Nat Clin Pract Gastroenterol Hepatol; 2005. Available:https://doi.org/10.1038/ncpgasthep0323
Gastroenterology B, Salas M, Ward A, Caro J. BMC Gastroenterology Are proton pump inhibitors the first choice for acute treatment of gastric ulcers? A Meta Analysis of Randomized Clinical Trials; 2002. Available:http://www.biomedcentral.com/1471-230X/2/17
Enns RA, Gagnon YM, Rioux KP, Levy AR. Cost-effectiveness in Canada of intravenous proton pump inhibitors for all patients presenting with acute upper gastrointestinal bleeding, Aliment Pharmacol Ther. 2003;17:225–233.
Tripathi D, Stanley AJ, Hayes PC, Patch D, Millson C, Mehrzad H, et al. UK guidelines on the management of variceal haemorrhage in cirrhotic patients, Gut. 2015;64:1680–1704. Available:https://doi.org/10.1136/gutjnl-2015-309262
Endoscopic sclerotherapy versus variceal ligation in the long-term management of patients with cirrhosis after variceal bleeding. A prospective randomized study - PubMed, (n.d.).
(Accessed August 25, 2023).
Blaisdell PC. Office ligation of internal hemorrhoids, The American Journal of Surgery. 1958;96:401–404.
Shaheen NJ, Stuart E, Schmitz SM, Mitchell KL, Fried MW, Zacks S, Met al. Pantoprazole reduces the size of postbanding ulcers after variceal band ligation: A randomized, controlled trial, Hepatology. 2005;41:588–594.
Trikudanathan G, Israel J, Cappa J, O’Sullivan DM. Association between proton pump inhibitors and spontaneous bacterial peritonitis in cirrhotic patients - A systematic review and meta-analysis, Int J Clin Pract. 2011;65:674–678.
Lo GH, Perng DS, Chang CY, Tai CM, Wang HM, Lin HC. Controlled trial of ligation plus vasoconstrictor versus proton pump inhibitor in the control of acute esophageal variceal bleeding, Journal of Gastroenterology and Hepatology (Australia). 2013;28:684–689. Available:https://doi.org/10.1111/jgh.12107
Hidaka H, Nakazawa T, Wang G, Kokubu S, Minamino T, Takada J, et al. Long-term administration of PPI reduces treatment failures after esophageal variceal band ligation: A randomized, controlled trial, J Gastroenterol. 2012;47: 118–126.
Lo EAG, Wilby KJ, Ensom MHH. Use of Proton Pump Inhibitors in the Management of Gastroesophageal Varices: A Systematic Review, Annals of Pharmacotherapy. 2015;49:207–219. Available:https://doi.org/10.1177/1060028014559244
Dultz G, Piiper A, Zeuzem S, Kronenberger B, Waidmann O. Proton pump inhibitor treatment is associated with the severity of liver disease and increased mortality in patients with cirrhosis, Aliment Pharmacol Ther. 2015;41:459–466.
Kang SH, Yim HJ, Kim SY, Suh SJ, Hyun JJ, Jung SW, et al. Proton pump inhibitor therapy is associated with reduction of early bleeDing risk after prophylactic endoscopic variceal band ligation a retrospective cohort study, Medicine (United States). 2016;95:1–9. Available:https://doi.org/10.1097/MD.0000000000002903
Wu CK, Liang CM, Hsu CN, Hung TH, Yuan LT, Nguang SH, et al. The role of adjuvant acid suppression on the outcomes of bleeding esophageal varices after endoscopic variceal ligation, PLoS One. 2017;12:1–15.
Elseidy SA, Sayed A, Awad AK, Mandal D, Mostafa M, Adigun A, et al. PPI efficacy in the reduction of variceal bleeding incidence and mortality , a meta analysis, Egypt J Intern Med; 2022. Available:https://doi.org/10.1186/s43162-022-00156-2
Dai C, Liu WX, Jiang M, Sun MJ. Endoscopic variceal ligation compared with endoscopic injection sclerotherapy for treatment of esophageal variceal hemorrhage: A meta-analysis, World J Gastroenterol. 2015;21.
Schoonbroodt D, Zipf A, Jung M. Local necrosis and fatal perforation of oesophagus after endoscopic ligation, Lancet. 1994;344:1365. Available:https://doi.org/10.1016/S0140-6736(94)90723-4
Gross and microscopic findings in the human esophagus after esophageal variceal band ligation: A postmortem analysis - PubMed, (n.d.). Available:https://pubmed.ncbi.nlm.nih.gov/8424432/
(Accessed August 25, 2023).
Toyoda H, Fukuda Y, Katano Y, Ebata M, Nagano KI, Morita K, et al. Fatal bleeding from a residual vein at the esophageal ulcer base after successful endoscopic variceal ligation, J Clin Gastroenterol. 2001;32:158–160. Available:https://doi.org/10.1097/00004836-200102000-00014
Symptomatic esophageal stricture after endoscopic variceal ligation--success of endoscopic balloon dilation - PubMed, (n.d.).
(Accessed August 25, 2023).