Article Details : |
| | Article Name : | | Helicobacter pylori and portal hypertensive
gastropathy diagnosed by narrow band imaging
(NBI): The role of its eradication
| Author Name : | | ESLAM SAFWAT
HANY ALY HUSSEIN
HANY SAMIR RASMY1, SARAH ADEL HAKIM, EHAB HAMED ELSAYED | Publisher : | | Bridge Center | Article URL : | | | Abstract : | | Background and Aim: Portal hypertensive gastropathy
(PHG) is a common endoscopic finding in patients with portal
hypertension. The pathophysiology of this condition is not obviously
understood. Although portal hypertension remains the crucial trigger
for the development of PHG, other factors could be responsible for the
progression of this condition. The aim of this study was to evaluate the
prevalence of helicobacter pylori (H. pylori) infection among cirrhotic
patients with PHG diagnosed by using narrow band imaging (NBI)
system and to asses the role of its eradication in improvement of PHG.
Patients and Methods: This study included 120 consecutive
patients with HCV-related liver cirrhosis. All patients were subjected
to an upper gastrointestinal endoscopy using NBI technique and
histopathologic testing of H. pylori. The diagnosis and the severity of
PHG were assesed on doing endoscopy. Child-Pugh score was calculated to assess the severity of liver cirrhosis. Concomitant
nonbismuth quadruple eradication therapy was given to H. pylori
postive patients with PHG. One month later after treatment, a second
endoscopic assesment of PHG was done to those with confirmed
eradicated H. pylori infection patients (using H. pylori stool antigen
test).
Results: PHG was detected in 78 patients with overall
prevalence 65%. Out of those 78 patients, 36 had mild PHG (46.15 %)
and 42 had severe PHG (53.85 %). A total of 90 patients out of 120
confirmed to have H. pylori infection with overall prevalence of 75 %.
The prevalence of H. pylori was higher among those with severe PHG
(36 out of 42; 85.7%) rather than those with mild PHG (24 out of 36;
66.7%) and without PHG (30 out of 42; 71.4%) (p=0.12). On reassesment of H. pylori associated PHG cured cases (n=42) by a second
endoscopic examination; the number of patients with mild PHG
decreased from 18 to 12 patients, as 6 of them became without PHG,
however none of patients with severe PHG showed any improvement
(n=24) (p=0.014)
Conclusion: There may be a minor role for H. pylori infection
in PHG due to HCV-related liver cirrhosis and eradication of H. pylori
may improve mild but not severe PHG. | Keywords : | | Portal hypertensive gastropathy, Narrow band imaging,
helicobacter pylori, liver cirrhosis
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