Gastric pH and Acid-suppressive Therapy in Patients with Liver Cirrhosis

Park, Cheol Gu; Kim, Seong Jun; Lee, Jin Ho; Choi, Won Choong; Kim, Kwan Yeop; Han, Tae Hui

Abstract

BACKGROUND/AIMS: Bacterial overgrowth in the small intestine can induce bacterial translocation and spontaneous bacterial peritonitis in liver cirrhosis patients, which is probably associated with alkaline gastric juice. We assessed the frequency of achlorhydria (pH>4) for the purpose of rational use of acid-suppressive therapy in liver cirrhosis patients. METHODS: Twenty-eight liver cirrhosis patients and 33 health examinee for screening stomach cancer were enrolled. The pH of fundal gastric juice aspirated through endoscope after overnight fast were measured with pH meter. The patients who had peptic ulcer disease, stomach cancer, history of upper G-I bleeding and experience of acid-suppressive drug (ASD) treatment before endoscopy were excluded. Chart review was undertaken to determine the use of ASD after endoscopy. RESULTS: The average gastric pH was 4.58+/-1.76 in the liver cirrhosis group and 3.48+/-1.48 in the control group (p<0.05). Fifty-seven percent (17/28) of liver cirrhosis patients and 75% (12/16) of the patients receiving ASD prescription among liver cirrhosis patients were achlorhydria at fasting state. CONCLUSIONS: Our study confirms that pH of liver cirrhosis patients is higher than that of control. Further studies for the rational use of ASD to the patients with liver cirrhosis is required, as a large number of achlorhydria patients exist in liver cirrhosis.