The role of Helicobacter pylori in cirrhotic patients: fact or fictions

Aim: The purpose of this study was to evaluate the evidence of the pathogenic role of Helicobacter pylori infection in patients with cirrhosis of the liver. Patients and metods: 80 patients (68M/12 F) mean age 48.5 yrs with cirrhosis of the liver were included in the study. All patients had upper gastroduodenal endoscopy and gastroduodenal pathology was identified. Helicobacter pylori infection was confirmed by gastric histology. The patients were divided into two groups. Group A- 40 patients with Helicobacter pylori infection and Group B- 40 patients without Helicobacter pylori infection. The age and sex of two studied groups were comparable. The effect variables were: stay in the ICU, peptic ulcer disease, levels of serum ammonia, hepatic encephalopathy, mortality and surgery treatment. Results: The incidence of peptic ulcer disease was significantly higher in Group A – 29 patients from 40 patients (74%) compared to Group B- 19 patients from 40 patients (51%). The mean levels of serum ammonia in Group A was significantly higher -27 patients from 40 patients (68%) compared to Group B- 16 patients from 40 patients (39%). P< 0.001. The episodes of hepatic enccephalopathy were significantly lower in Group B (3.6), compared to Group A (8.2). P< 0.001. The duration of stay in the ICU in Group A (6.8 days) was significantly higher compared with Group B (8.2 days). P< 0.001. No significant difference was found for surgical inntervention and mortality into two groups. Student T- test, Friedman and Wilcoxon Signed Ranks test were used. Conclusion: According to our results we found that H. pylori infection are the major risk factors for peptic ulcers in patients with cirrhosis of the liver. The mean levels of serum ammonia in patients with H.pylori infection were higher than in patients without H. pylori infection.