Clinical practice guideline for appropriate use of gastric acid suppressants in gastrointestinal surgery (2022 edition)

Abstract

Gastric acid suppressants, such as proton pump inhibitors, are one of the most widey used drugs worldwide. There is a very high frequency of abuse of gastric acid suppressants, leading huge waste of medical resources. Moreover, numerous studies have showed that acid suppressants were associated with a variety of adverse events, such as fractures and intestinal infections. Increasing guidelines and consensuses have been made to guide the appropriate use of acid suppressants. Gastrointestinal surgery is one of the fields with the largest prescriptions of acid suppressants. Acid suppressants are widely used for preventing anastomotic bleeding after upper gastrointestinal surgery, treating gastrointestinal bleeding and etc. However, most of these prescriptions are off-label uses lacking adequate evidentiary basis. Thus far, there is no guideline specific for appropriate use of acid suppressants in digestive surgeries. Therefore, Chinese Society of Upper Gastrointestinal Surgeons (CSUGS) and Chinese Gastric Cancer Association (CGCA) developed this clinical practice guideline based on the best research evidence and clinical expertise. The aim is to guide the appropriate use of gastric acid suppressants in gastrointestinal surgery, which in turn, increase the benefits of patients.