European Academic Research ISSN 2286-4822
ISSN-L 2286-4822
Impact Factor: 3.4546 (UIF)
DRJI Value : 5.9 (B+)
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 Rasmy, 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 re-assesment 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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