Correlation of Portal Hypertensive Gastropathy with Helicobacter Pylori Infection, Liver Dysfunction, Hypersplenism and Oesophageal Varices
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- Category: Vol. 77, December 2009
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Correlation of Portal Hypertensive Gastropathy with Helicobacter Pylori Infection, Liver Dysfunction, Hypersplenism and Oesophageal Varices,OSAMA MOHAMAD HAMMAD, MOHAMAD AHMAD ABU-SEIF, MAGDY ASHOUR and TAMER HIFNAWY
Abstract
Background: Portal hypertensive gastropathy (PHG) is a common endoscopic finding in patients with portal hyperten-sion. The pathophysiology of this condition is not clearly understood. Although portal hypertension remains the crucial trigger for the development of PHG, other factors should be considered in the progression of this condition.
Study Aims: The aim of this study was to investigate the role of H. pylori infection, liver function, hypersplenism and oesophageal varices in development and severity of PHG.
Patients and Methods: This case control study included 60 cases with liver cirrhosis and PHG and 30 healthy individ-uals with non ulcer dyspepsia as a control group. Among patients group, liver cirrhosis was diagnosed by clinical, biochemical, sonographic and/or histopathological criteria of cirrhosis. After having the informed consent signed from all study subjects for participation in the study, all patients were subjected to upper gastrointestinal (GIT) endoscopy to assess the grades of oesophageal varices and PHG and four antral biopsies were taken for detection of H. pylori infection by histopathological examination. The grade of liver dysfunction was assessed according to Child-Pugh scoring system and grade of hypersplenism was assessed by reduction of white blood cells (WBCs),haemoglobin (HGB) and platelates (PLT). In control group, upper GIT endoscopy was done to them and four antral biopsies were taken for histopathological exami-nation for detection of H. pylori infection. Individuals of control group and positive for H.pylori infection were subjected to triple therapy (clarithromycin, amoxicillin and omeprazole) for one week to eradicate this infection.
Results: There was statistically insignificant difference between the prevalence of H. pylori infection in PHG patients (70%) and control group (63.3%). The prevalence of H. pylori infection was statistically lower in patients with severe PHG (45.5%) than those with mild PHG (84.2%). There was statis-tically significant correlation between grade of PHG and grades of liver dysfunction, hypersplenism and oesophageal varices.
Conclusion: Our data showed that the H. pylori infection did not correlate with PHG, but severe PHG was significantly associated with less H. pylori infection. There was significant
correlation between grade of severity of PHG and grade of liver dysfunction, hypersplenism and oesophageal varices.