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

  • Authors:
    • Fei Yu
    • Yue Zhu
    • Na Li
    • Hong-Fang Fu
    • Zhi Jiang
    • Xiao-Yi Zhang
    • Liang Zeng
    • Xiao-Yu Hu
  • View Affiliations / Copyright

    Affiliations: Department of Infectious Diseases, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, P.R. China
    Copyright: © Yu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 414
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    Published online on: July 12, 2023
       https://doi.org/10.3892/etm.2023.12113
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Abstract

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.
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Copy and paste a formatted citation
Spandidos Publications style
Yu F, Zhu Y, Li N, Fu H, Jiang Z, Zhang X, Zeng L and Hu X: Gastro‑oesophageal reflux disease in liver cirrhosis: Possible pathogenesis and clinical intervention (Review). Exp Ther Med 26: 414, 2023.
APA
Yu, F., Zhu, Y., Li, N., Fu, H., Jiang, Z., Zhang, X. ... Hu, X. (2023). Gastro‑oesophageal reflux disease in liver cirrhosis: Possible pathogenesis and clinical intervention (Review). Experimental and Therapeutic Medicine, 26, 414. https://doi.org/10.3892/etm.2023.12113
MLA
Yu, F., Zhu, Y., Li, N., Fu, H., Jiang, Z., Zhang, X., Zeng, L., Hu, X."Gastro‑oesophageal reflux disease in liver cirrhosis: Possible pathogenesis and clinical intervention (Review)". Experimental and Therapeutic Medicine 26.3 (2023): 414.
Chicago
Yu, F., Zhu, Y., Li, N., Fu, H., Jiang, Z., Zhang, X., Zeng, L., Hu, X."Gastro‑oesophageal reflux disease in liver cirrhosis: Possible pathogenesis and clinical intervention (Review)". Experimental and Therapeutic Medicine 26, no. 3 (2023): 414. https://doi.org/10.3892/etm.2023.12113
Copy and paste a formatted citation
x
Spandidos Publications style
Yu F, Zhu Y, Li N, Fu H, Jiang Z, Zhang X, Zeng L and Hu X: Gastro‑oesophageal reflux disease in liver cirrhosis: Possible pathogenesis and clinical intervention (Review). Exp Ther Med 26: 414, 2023.
APA
Yu, F., Zhu, Y., Li, N., Fu, H., Jiang, Z., Zhang, X. ... Hu, X. (2023). Gastro‑oesophageal reflux disease in liver cirrhosis: Possible pathogenesis and clinical intervention (Review). Experimental and Therapeutic Medicine, 26, 414. https://doi.org/10.3892/etm.2023.12113
MLA
Yu, F., Zhu, Y., Li, N., Fu, H., Jiang, Z., Zhang, X., Zeng, L., Hu, X."Gastro‑oesophageal reflux disease in liver cirrhosis: Possible pathogenesis and clinical intervention (Review)". Experimental and Therapeutic Medicine 26.3 (2023): 414.
Chicago
Yu, F., Zhu, Y., Li, N., Fu, H., Jiang, Z., Zhang, X., Zeng, L., Hu, X."Gastro‑oesophageal reflux disease in liver cirrhosis: Possible pathogenesis and clinical intervention (Review)". Experimental and Therapeutic Medicine 26, no. 3 (2023): 414. https://doi.org/10.3892/etm.2023.12113
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