Abstract / Summary
Cirrhosis, the end-stage outcome of chronic liver injury, is frequently accompanied by acid-related gastrointestinal complications, for which proton pump inhibitors (PPIs) are widely prescribed, although evidence supporting their routine use in this vulnerable population remains limited. Objective: This cross-sectional observational study assessed the clinical profile, prescribing pattern, and adverse effect burden of PPIs in cirrhotic patients attending the Gastroenterology Department, King George Hospital, Visakhapatnam. Methods: A total of 100 cirrhosis patients were enrolled over six months, and demographic, clinical, and therapeutic data were collected through patient and caregiver interviews and prescription review. Results: The study population was predominantly male (72%), with alcoholic liver disease the leading cause of cirrhosis (49%), followed by unspecified aetiologies (29%) and hepatitis B (11%). PPIs were used by 68% of patients, most often initiated for ulcer bleeding (42%) or abdominal pain (24%), with pantoprazole the most commonly prescribed agent (89%). Endoscopy was performed in 82% of patients, revealing ulcers in a substantial proportion of cases, and antibiotics (50%) and diuretics (36%) were the most common concomitant medications. Clinical improvement of 75% or greater was observed in more than half of PPI users. Insomnia (15%), headache, anorexia, and abdominal pain (9% each), and bloating and constipation (7% each) were the most frequently reported adverse effects, while 49% of patients experienced none. Conclusion: PPIs offer meaningful clinical benefit in managing gastrointestinal complications of cirrhosis, but their adverse effect profile warrants cautious, individualized prescribing supported by regular monitoring and larger, longer-term studies.