THE THERAPEUTIC ROLE OF SUCRALFATE IN POST-VARICEAL BAND LIGATION AT A TERTIARY CARE HOSPITAL

Abstract

Background: Endoscopic variceal band ligation (EVBL) is a standard intervention for preventing variceal bleeding in patients with liver cirrhosis. However, the procedure often leads to post-ligation ulcers, pain, dysphagia, and potential bleeding complications, increasing patient morbidity and hospital stay. Sucralfate, a gastroprotective agent, has demonstrated efficacy in accelerating ulcer healing and reducing gastrointestinal symptoms in various conditions. Its role in post-EVBL care remains underexplored, necessitating further investigation.

Objective: To evaluate the efficacy of sucralfate in improving post-EVBL outcomes, including ulcer healing, pain relief, dysphagia reduction, prevention of post-ligation bleeding, and hospital stay duration.

Methods: This cross-sectional study was conducted at the Gastroenterology and Hepatology Unit of PEMH Hospital, enrolling 200 patients who underwent EVBL. Participants were randomized into two groups: Group A received oral sucralfate (1g, four times daily for 14 days) along with standard care, while Group B received only standard care, including proton pump inhibitors and dietary modifications. Clinical parameters, including ulcer healing, pain intensity, dysphagia incidence, bleeding episodes, and hospital stay duration, were assessed at Day 7 and Day 14. Statistical analyses were performed using SPSS 23, with significance set at p<0.05.

Results: Ulcer healing at Day 14 was significantly higher in the sucralfate group (70%) compared to the control group (45%) (p<0.001). Moderate to severe pain at Day 7 was lower in the sucralfate group (25% vs. 50%, p=0.003), with persistent pain at Day 14 reduced to 5% versus 20% (p=0.01). Dysphagia prevalence declined from 12% to 3% in the sucralfate group, compared to 28% to 15% in controls (p=0.008). Post-ligation bleeding was lower in the sucralfate group (8% vs. 18%, p=0.04), with fewer transfusions required (6% vs. 14%, p=0.03). Hospital stay was shorter in the sucralfate group (3.5±1.2 vs. 5.2±1.6 days, p<0.001). Sucralfate reduced multiple ulcer formation risk (Adjusted OR=0.6, p=0.05).

Conclusion: Sucralfate significantly improves post-EVBL recovery by enhancing ulcer healing, reducing pain and dysphagia, minimizing bleeding risk, and shortening hospital stay. Incorporating sucralfate into post-ligation care protocols may improve patient outcomes. Further large-scale randomized trials are needed to confirm these findings.