Review article: Oesophageal disorders in chronic liver disease

• Published in: Alimentary pharmacology & therapeutics Vol. 60; no. 6; pp. 715 - 726
• Main Authors: Idalsoaga, Francisco, Díaz, Luis Antonio, Ayares, Gustavo, Cabrera, Daniel, Chahuan, Javier, Monrroy, Hugo, Halawi, Houssam, Arrese, Marco, Arab, Juan Pablo
• Format: Journal Article
• Language: English
• Published: Chichester Wiley Subscription Services, Inc 01.09.2024
• Subjects: Barrett's esophagus; Candidiasis; Cirrhosis; Disease management; Epidemiology; Esophageal cancer; Gastroesophageal reflux; Liver cancer; Liver cirrhosis; Liver diseases; Medical treatment; Movement disorders; Pathophysiology; Pharmacokinetics; Proton pump inhibitors; Quality of life; Side effects
• ISSN: 0269-2813; 1365-2036; 1365-2036
• DOI: 10.1111/apt.18193

Summary Background Oesophageal disorders and chronic liver disease are common worldwide and significantly impact quality of life. The intricate link between these conditions, including how oesophageal disorders like GERD, Barrett's oesophagus and oesophageal cancer affect and are affected by chronic liver disease, remains poorly understood. Aims To review the relationship between oesophageal disorders and chronic liver disease, evaluating epidemiology, pathophysiology and therapeutic factors. Methods We reviewed the literature on the relationship between oesophageal disorders and chronic liver disease, including cirrhosis, using the PubMed database Results Oesophageal disorders such as gastroesophageal reflux disease, Barrett's oesophagus, oesophageal cancer, oesophageal motor disorders and oesophageal candidiasis are prevalent among individuals with cirrhosis, exacerbating the burden of liver disease. These diseases have a multifaceted symptomatology and pathogenic basis, posing a significant challenge in cirrhotic patients that necessitates careful diagnosis and management. Additionally, therapies frequently used for these diseases, such as proton pump inhibitors, require careful consideration in cirrhotic patients due to potential adverse effects and altered pharmacokinetics. Managing oesophageal disorders in cirrhotic patients requires a cautious approach due to possible interactions with medications and the risk of adverse effects. Furthermore, symptoms associated with these conditions are often exacerbated by common interventions in patients with cirrhosis, such as band ligation for oesophageal varices. Conclusions Oesophageal disorders are common in cirrhosis and increase the disease burden. These conditions require careful management due to complex symptoms and treatment risks. Proton pump inhibitors and other therapies must be used cautiously, as cirrhosis interventions can worsen symptoms. Oesophageal disorders such as GERD, Barrett's oesophagus, cancer, motor disorders and candidiasis are common among cirrhotic patients, complicating management and impacting quality of life. Understanding their complex interplay in cirrhotic patients is crucial, revealing significant challenges.