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

Abstract Aims Proton 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. Methods Cirrhotic 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. Results During 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). Conclusions PPI did not appear to reduce variceal bleeding and adverse events in patients with cirrhosis after endoscopic therapy.