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Helicobacter pylori infection in congestive gastropathy
A Bahnacy1, P Kupcsulik, Z Elés
1Department of Internal Medicine, Semmelweis Medical University, Budapest, Hungary.
Insights
Helicobacter pylori (H. pylori) infection is not a significant factor in the development of congestive gastropathy in patients with portal hypertension. Routine eradication of H. pylori is not recommended for these patients.
Area of Science:
- Gastroenterology
- Hepatology
- Infectious Diseases
Context:
- Portal hypertension is a serious complication of liver disease.
- Congestive gastropathy is a common gastrointestinal manifestation in portal hypertension.
- The role of Helicobacter pylori in gastrointestinal pathology is well-established, but its specific involvement in portal hypertensive gastropathy requires further clarification.
Purpose:
- To investigate the prevalence and significance of Helicobacter pylori infection in patients with portal hypertension.
- To determine the association between H. pylori status and the presence and severity of congestive gastropathy.
- To assess the need for H. pylori eradication in cirrhotic patients with portal hypertension.
Summary:
- A study involving 118 patients (90 with portal hypertension, 28 controls) found H. pylori in 47% of portal hypertensive patients with gastropathy and 53% without gastropathy.
- The control group showed a 54% H. pylori positivity rate.
- H. pylori was less frequent in gastropathy patients than controls, and its presence/severity was independent of gastropathy.
Impact:
- The findings suggest that H. pylori plays an unlikely role in the pathogenesis of congestive gastropathy.
- Routine eradication of H. pylori is not indicated for cirrhotic patients experiencing portal hypertension.
- This research may influence clinical guidelines regarding H. pylori management in liver disease patients.
Background:
This study determines the prevalence and significance of Helicobacter pylori infection in portal hypertensive patients.
Materials And Methods:
Patients numbered 118 and consisted of 90 patients with portal hypertension (66 men; 24 women; mean age, 49.1 +/- 2.1 years) and 28 noncirrhotic patients with nonulcer dyspepsia, (12 men; 16 women; mean age, 47.6 +/- 2.8 years), who made up the control group. In all patients, diagnostic upper endoscopy was performed, and gastric biopsies were taken for histological examination and diagnosis of H. pylori.
Results:
Of the portal hypertensive patients, 42 (47%) had congestive gastropathy, 11 (26%) of whom were positive for H. pylori, and 48 (53%) did not have gastropathy, 12 (25%) of whom were positive for H. pylori. In the control group, 15 of 28 (54%) were positive for H. pylori. H. Pylori was found less frequently in congestive gastropathy patients than in the control group. We found also that the presence and severity of congestive gastropathy is independent of H. pylori status.
Conclusions:
We conclude that the role of H. pylori in the pathogenesis of congestive gastropathy is unlikely, and we suggest that there is no need for its routine eradication in cirrhotic patients.