I finally got around to researching more about: Why DO doctors give PPIs to patients? I mean, why do they really give them? When it comes to medications, it's clear why patients take almost all the different medications. We know the lactulose is to help a person go to the bathroom and keep bacteria (and therefore, ammonia) from building up, and causing encephalopathy. We know diuretics are to reduce swelling and fluid buildup in the body and abdomen. We know antibiotics are to prevent an infection.
But it's still not entirely clear why Proton Pump Inhibitors are prescribed for almost all cirrhosis patients. And to be honest, I think even some doctors don't fully understand what they really do to the patients they're giving them to.
If you want to see more about why I am NOT a fan of PPIs, please read THIS POST (and click on the links for the other posts on that page, and have a look at my husband's cracked tongue). This photo might surprise you, like it surprised me.
I understand that doctors like to give that whole "well, you have to outweigh the benefits vs. the negative side effects" but so far I haven't seen the benefits.... just the side effects. Maybe their use would be justified in the case for someone who's had surgery, but my husband didn't have surgery, so in my opinion, their use was never really justified.
The general vibe you get from doctors is that PPIs are given because doctors believe they reduce a person's risk of bleeding from their esophagus or stomach. I get it. Bleeding to death would be a very bad thing. But I really do question how much the PPIs help most cirrhotics in this regard, and studies show not everyone is at risk (particularly if you haven't had surgery).
Yes, you DO have to weigh the risks vs. the side effects. It's easy for doctors to prescribe things for people across the board, when they have an extreme fear, and nothing sounds scarier than bleeding to death. But how much do the PPIs really prevent this? Especially when PPIs can cause MORE scar tissue and make a person's cirrhosis WORSE?
Please have a look at this study (pasted below).
Minor Endpoints: Need for endoscopic hemostasis, Blood transfusion, Decrease in Hospital Days.
Four randomized control trials comprising of almost 1500 patients were included in the analysis. In this systematic review, PPIs failed to reduce death, re-bleeding rates, or the need for surgery. They did reduce the incidence of high risk lesions found during endoscopic evaluation. There was not sufficient evidence to assess for amount of blood transfused or decrease in hospitalized days, though one trial in the review and one recent trial (citation) showed that there was no difference in either.
Please note the term "high risk lesions" (underlined above). In my opinion, if a person has an endoscopy, and they do not find any high risk lesions, then IN MY OPINION the side effects negate the benefits of taking this medication. My husband had an endoscopy and there was no sign of bleeding or high risk lesions. I saw the pictures with my own eyes. In my opinion he should never have been given the PPIs, and certainly not for NINE MONTHS STRAIGHT.
My OPINION is that, if a person doesn't have bulging varices, or isn't having a surgical procedure in their throat or stomach, then the risks outweigh the benefits. And I even question their safety if a person DOES have a surgical procedure, but that's up to each person to do their own research and decide for themselves.
When you use strong cleaners like household bleach, every day, to kill pathogens in your kitchen, you're giving your family "an extra layer of protection" against bacteria.... while you're also exposing them to toxic poisons that are likely to make them sick in the long run. You can call sh** a rose.... but that doesn't take away the stink.