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Helicobacter pylori and hepatic encephalopathy
A Duseja1, A Sachdev, R K Dhiman
1Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh.
Summary
Helicobacter pylori infection is linked to hepatic encephalopathy due to ammonia production. Eradicating H. pylori can improve ammonia levels and brain function in cirrhotic patients.
Area of Science:
- Gastroenterology and Hepatology
- Microbiology
Background:
- Extra-intestinal manifestations of Helicobacter pylori infection are increasingly recognized.
- Hepatic encephalopathy (HE) is a serious complication of liver cirrhosis.
- H. pylori infection is hypothesized to contribute to HE via ammonia production.
Purpose of the Study:
- To investigate the association between H. pylori infection and hepatic encephalopathy.
- To assess the role of ammonia in this association.
- To evaluate the effect of H. pylori eradication on HE and ammonia levels.
Main Methods:
- Comparative analysis of H. pylori prevalence in cirrhotic patients with and without HE.
- Measurement of ammonia levels in gastric juice and blood.
- Assessment of changes in ammonia levels and HE status following H. pylori eradication therapy.
Main Results:
- H. pylori infection is more prevalent in cirrhotic patients with hepatic encephalopathy.
- Elevated ammonia levels in gastric juice and blood are more common in cirrhotics with H. pylori infection.
- Eradication of H. pylori led to improvements in blood ammonia levels and hepatic encephalopathy.
Conclusions:
- Helicobacter pylori infection may play a role in the pathogenesis of hepatic encephalopathy in cirrhotic patients.
- Ammonia produced by H. pylori is a potential contributing factor.
- H. pylori eradication is a potential therapeutic strategy for improving HE in affected patients.