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H. pylori infection and hepatic encephalopathy in cirrhotic patients: Facts or fictions

Aim: of this study was to determine relationship between H. pylori (HP) infection and severity of hepatic encephalopathy (HE) in cirrhotic patients. Patients and Methods: 80 patients (66M/14F) mean age 54. 3 yrs with cirrhosis of the liver were included in the study. The patients were divided into two groups. Group A: 40 patients with liver cirrhosis and HE and Group B:40 patients with liver cirrhosis without HE. All patients had upper gastroduodenal endoscopy and gastroduodenal pathology was identified. HP infection was confirmed by gastric histology. Patients were evaluated for biochemical tests, blood ammonia concentration, Child-Pugh class A, B and C, and active peptic ulcers. Results: The incidence of HP infection was significantly higher in Group A:27 patients from 40 patients (67%) compared with group B:16 patients from 40 patients (40%). P < 0.001. In patients with encephalopathy HP infection was more among alcoholics (25 patients from 40 (62.5%) in comparison to nonalcoholics patients - 15 patients from 40 patients (37.5%). P < 0.001. The level of blood ammonia concentration was significantly higher in group A: 25 patients from 40 patients (62%) than in group B - 12 patients from 40 patients (30.0%). P < 0.001. In group A - 12 patients from 40 patients (30%) had peptic ulcer compared with group B- 5 patients from 40 patients (12.5%). P < 0.001. Conclusion: Our data suggest that H. pylori infection is an important factor for inducing high blood ammonia concentration and hepatic encephalopathy in cirrhotic patients, especially in alcoholic patients. HP eradication may be useful for treatme of HE. We found also that HP infection and liver cirrhosis are important factors associated with active peptic ulcer.

H. pylori; hepatic encephalopathy; liver cirrhosis

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