Helicobacter pylori in Cirrhotic Patients with Peptic Ulcer Disease: a Prospective, Controlled Case Study

Yi, Sun Young

Abstract

BACKGROUND
There is an increased prevalence of peptic ulcer disease in patients with liver cirrhosis, but the role of Helicobacter pylori is unclear. METHOD: IgG antibodies against H. pylori were measured in 30 patients with compensated liver cirrhosis, in 30 sex- and age-matched patients with decompensated liver cirrhosis, and 30 normal controls. All patients underwent a panendosocpic examination in order to search for the evidence of esophageal varices, congestive gastropathy, and peptic ulcers.
RESULTS
Duodenal ulcers were more common in compensated and decompensated cirrhotic patients (13.3% and 13.3%, respectively) than in the normal controlled group (6.7%, p<0.05). The prevalence of H. pylori was not statistically different among the three groups (normal 63.3%, compenstated 63.3%, and decompensated, 70.0%; p > 0,05). The prevalence of H. pylori also showed no statistical differences in respect to duodenal ulcers (100%, 75%, and 75%, repectively, p>0.05) or gastric ulcers (100%, 100%, and 60%, respectively, p >0.05). The prevalence of an H. pylori infection did not differ significantly in relation to the presence or absence of esophageal varices or of congestive gastropathy. In cirrhotic patients with peptic ulcers, the prevalence of H. pylori was lower in the presence of esopahgeal varices (60.0% vs 100% if without varices, p=0.04) and in the presence of congestive gastropathy (50.0% vs 88.9% p=0.03).
CONCLUSIONS
The prevalence of peptic ulcer was increased in cirrhotic patients, but the prevalence of H. pylori was similar in compensated cirrhotic patients, decompensated cirrhotic patinets, and in the normal controlled group. The frequency of non-H. pylori associated with peptic ulccrs in cirrhotic patients was increased in the presence of an esophageal varix or a congestive gastropathy.