Determining the Risk of Spontaneous Bacterial Peritonitisdue to increase use of Proton Pump Inhibitors among cirrhotic patients with ascites

Shaikh, Bashir Ahmed; Shaikh, Zahid Ali; Shah, Aftab Hussain; Kumar, Aneel

doi:10.12669/pjms.37.4.3476

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…Similarly, a prospective study has found that in rats with cirrhosis induced by common bile duct ligation, the improvement of hyperhomocysteinemia can substantially reduce both portal pressure and the risk of occurrence of CLD-related adverse events including HE and gastrointestinal bleeding [ 17 , 18 ]. An additional study on SBP in CLD victims has found interrelationship between serum homocysteine and SBP, and the level of serum homocysteine serves as a predictor for CLD-SBP [ 19 , 20 ]. Recently, high concentrations of bile acids have been found in the cerebrospinal fluid of patients with liver cirrhosis [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Risk Factor Analysis of Hepatic Encephalopathy and the Establishment of Diagnostic Model

Chen

Zhang

et al. 2022

BioMed Research International

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To identify laboratory diagnostic indicators of hepatic encephalopathy (HE), the present study established a HE diagnostic model to explore the diagnostic value of serum homocysteine, lactic acid, procalcitonin, and bile acid levels in HE identification. 371 patients with liver cirrhosis were selected as research objects, who were admitted to the Department of Hepatic Diseases, Affiliated Hospital of Northwest Minzu University from August 2019 to August 2020. The Spearman correlation results indicated that between lactic acid, procalcitonin, bile acid, serum homocysteine, and HE, the coefficients were -0.15, 0.41, 0.29, and -0.19, respectively. Univariate and multivariate analysis methods were adopted for inpatient analysis to identify the influencing factors of HE occurrence, and the diagnosis of the HE identification model was subsequently constructed. The univariate logistic regression showed that risk of developing HE increased as bile acid level ( P = 0.00434 ) and serum homocysteine ( P = 0.058 ) increased. Multivariate logistic regression diagnostic model of bile acid level and serum homocysteine revealed that the AUC value of the area under the ROC curve was 0.7201, indicating that the diagnostic model produced a satisfactory evaluation effect. The model formula referred logistic P = − 2.4544 + 0.0117 bile acid levels + 0.0198 serum homocysteine . In this study, the HE diagnostic model was established using logistic regression analysis, which could benefit patients in early HE differential diagnosis. Particularly, combined detection of serum homocysteine and bile acid levels was considered to be more significant.

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Section: Discussionmentioning

confidence: 99%

Risk Factor Analysis of Hepatic Encephalopathy and the Establishment of Diagnostic Model

Chen

Zhang

et al. 2022

BioMed Research International

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“…PPI should be administered to patients who will benefit from its use. In elderly patients with severe liver injury, particularly those with ascites in LC, PPI treatment should be avoided or administered with caution to lower the risk of SBP (75)(76)(77).…”

Section: Clinical Interventionmentioning

confidence: 99%

Gastro‑oesophageal reflux disease in liver cirrhosis: Possible pathogenesis and clinical intervention (Review)

Zhu

et al. 2023

Exp Ther Med

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Oesophageal variceal bleeding is a common complication of decompensated liver cirrhosis (LC). Some studies have reported that reflux oesophagitis (RE) is a risk factor for upper gastrointestinal bleeding, and greatly impacts the quality of life. However, the frequency and mechanism of gastro-oesophageal reflux disease (GERD) in LC remain unclear. The present review explored the possible pathogenesis, and analysed the advantages and disadvantages of the interventional measures and the need for implementation of these measures. By combining the comprehensive terms associated with LC, GERD and RE, EMBASE, Medline/PubMed and the Cochrane Library were systematically searched. The underlying pathological mechanism of GERD in LC was summarized: Transient relaxation of the lower oesophageal sphincter, delayed gastric emptying, increased intra-abdominal pressure, increased intragastric pressure and excessive nitric oxide production destroyed the 'anti-reflux barrier', causing gastric content reflux. Proton pump inhibitors (PPIs) have been widely used empirically to lower the risk of oesophageal venous rupture and bleeding. However, long-term use of acid inhibitors in patients with LC may induce complications, such as spontaneous bacterial peritonitis. The metabolic half-life of PPIs is prolonged in patients with severe liver function impairment. Therefore, the indications for using acid inhibitors lack clarity. However, after endoscopic oesophageal variceal eradication, additional benefits may be gained from the long-term use of PPIs in small doses. Contents 1. Introduction 2. Epidemiological investigation 3. Pathophysiological changes of GERD 4. Mechanism 5.

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Determining the Risk of Spontaneous Bacterial Peritonitisdue to increase use of Proton Pump Inhibitors among cirrhotic patients with ascites

Cited by 2 publications

References 23 publications

Risk Factor Analysis of Hepatic Encephalopathy and the Establishment of Diagnostic Model

Risk Factor Analysis of Hepatic Encephalopathy and the Establishment of Diagnostic Model

Gastro‑oesophageal reflux disease in liver cirrhosis: Possible pathogenesis and clinical intervention (Review)

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