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Peptic ulcer bleeding in patients with or without cirrhosis: different diseases but the same prognosis?

M Rudler1, G Rousseau, H Benosman

  • 1Department of Hepatogastroenterology, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie University, France. marika.rudler@psl.aphp.fr

Alimentary Pharmacology & Therapeutics
|May 22, 2012
PubMed

Insights

Peptic ulcer bleeding (PUB) in cirrhotic patients differs in cause, often linked to alcohol and portal hypertension, but shows similar outcomes to non-cirrhotic patients. This study highlights distinct PUB physiopathology in cirrhosis.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Internal Medicine

Background:

  • Peptic ulcer bleeding (PUB) is a significant clinical concern.
  • The specific physiopathology and prognosis of PUB in patients with cirrhosis remain underexplored.
  • Understanding these differences is crucial for patient management.

Purpose of the Study:

  • To investigate the risk factors associated with peptic ulcer bleeding (PUB) in patients with and without cirrhosis.
  • To compare the clinical outcomes of PUB between cirrhotic and non-cirrhotic patient groups.
  • To elucidate the unique characteristics of PUB in the context of liver cirrhosis.

Main Methods:

  • Prospective cohort study of 203 patients with PUB admitted to an ICU of Hepatology and Gastroenterology.
  • Patients were categorized into two groups: those with cirrhosis (Cirr+) and those without (Cirr-).
  • Comparison of aetiologies, clinical characteristics, and outcomes, including re-bleeding, interventions, and mortality.

Main Results:

  • Twenty-nine patients had cirrhosis (Cirr+), predominantly due to alcohol (97%).
  • Aetiologies of PUB differed significantly: Helicobacter pylori and NSAIDs were less common in Cirr+ patients, while idiopathic PUB was more frequent.
  • Outcomes such as re-bleeding, need for embolisation or surgery, and mortality were comparable between Cirr+ and Cirr- groups.

Conclusions:

  • Peptic ulcer bleeding in cirrhotic patients appears to have a different physiopathology, often associated with portal hypertension and alcohol consumption.
  • Despite differing aetiologies, the prognosis for PUB in cirrhotic patients in this series was similar to that in the general population.
  • Further research into the role of portal hypertension and alcohol in cirrhotic PUB is warranted.
Abstract

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