Factor Related to Peptic Ulcer in Cirrhotic Patients with Esophageal Variceal Bleeding

Abstract

Background and Aim: There is a higher prevalence of peptic ulcers in cirrhotic patients. Whether Helicobacter pylori (H. pylori) is a risk factor for peptic ulcer in cirrhosis remains controversial. There have been no studies in the literature on the factors predisposing to peptic ulcers in cirrhotic patients with a history of esophageal variceal bleeding. In this study, we evaluated the prevalence of H. pylori infection, portal hypertensive gastropathy and peptic ulcers in patients with liver cirrhosis to identify the factors predisposing to peptic ulcers in cirrhotic patients with a history of esophageal variceal bleeding.Patients and Methods: A total of 102 cirrhotic patients with a history of variceal bleeding who underwent regular endoscopic follow-up were enrolled. The prevalence of H. pylori infection in the cirrhotic patients was compared with that in 654 subjects who received a health check-up during a similar period in our hospital.Results: The infection rate of H. pylori was 35.3% in cirrhotic patients. Overall, gastric ulcers were noted in 51.9% and duodenal ulcers were noted in 32.4% of the cirrhotic patients with a history of variceal bleeding. Gastric ulcers were noted in 61.1% of patients with H. pylori infection and in 47% of patients without H. pylori infection. In addition, duodenal ulcers were noted in 30.6% of patients with H. pylori infection and in 31.8% of patients without H. pylori infection. Furthermore, only 19.6% of the cirrhotic patients were negative for any peptic ulcers. The status of H. pylori infection did not affect the severity of portal hypertensive gastropathy or the presence of gastric varices.Conclusions: Although there was a high incidence of peptic ulcers in cirrhotic patients, the prevalence of H. pylori infection was lower in cirrhotic patients and cirrhotic patients with duodenal ulcers than in non-cirrhotic patients. However, the status of H. pylori infection did not affect the severity of portal hypertensive gastropathy or the presence of gastric varices.