Many patients with liver disease are prescribed PPIs; however, there is a paucity of data regarding how these drugs affect prognosis in this group of patients. A new study prospectively enrolled 272 patients with cirrhosis, 213 of whom were receiving PPIs. Analyses revealed that the use of PPIs was associated with increased MELD scores and ascites, and was an independent predictor of mortality. Although the cause of this association is not known, the authors of the study suggest that prescribing PPIs to patients with cirrhosis now needs to be more carefully considered.