Proton Pump Inhibitors and Dysbiosis in Cirrhosis

The purpose of this study is to find out whether the use of medications that suppress acid in your stomach can change the composition of your bowel bacteria.

Inclusion Criteria for PPI initiation study:

• Cirrhosis not on current PPI or acid suppressive therapy
• No systemic antibiotics or probiotics

Exclusion Criteria for PPI initiation study:

• On systemic antibiotics
• On PPI or acid suppression therapy already
• unable to give informed consent
• Allergy to proton pump inhibitors

Inclusion Criteria for PPI withdrawal study:

• Cirrhosis on current PPI for an FDA-unapproved indication
• No systemic antibiotics or probiotics

Exclusion Criteria for PPI withdrawal study:

• On systemic absorbable antibiotics
• On PPI or acid suppression therapy for an FDA-approved indication
• unable to give informed consent
• unwilling to withdraw PPI