[Gastroduodenal lesions in patients with liver cirrhosis--pathogenesis and management]

Gastroduodenal lesions are a common complication in patients with liver cirrhosis. The etiology of this problem has been investigated from the standpoint of both mucosal protective factors and aggressive factors. Among the various mucosal protective factors, much emphasis has been placed on the disturbance of microcirculation in the gastric mucosa as a result of stasis in the portal vein. Duodenogastric reflux may be involved in the etiology of the gastric mucosal changes. And, Phospholipids levels in the gastric mucosa were reduced in cirrhosis. Regarding aggressive factors, there have been many reports of diminished secretion of gastric acid. But, patients with ulcer had a tendency to be higher gastric acidity than those without ulcer. Drugs increased mucosal defense might be effective in healing gastroduodenal lesions in cirrhosis. Despite the observation that acid secretion decreased in cirrhosis, inhibition of acid secretion induces ulcer healing. In cirrhosis, a high incidence of gastric cancer was reported, so that patients should be undergo periodic screening with endoscopy.