Helicobacter pylori Infection in Cirrhotic Patients With Portal Hypertensive Gastropathy: A New Enigma?

Abstract

The relationship between <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection and Portal hypertensive gastropathy (PHG) is still a debatable matter. The aim of this study is to find out how common <i>H. pylori</i> infection is in cirrhotic patients with PHG and to see if there's a link between <i>H. pylori</i> infection and PHG severity. Out of 340 cirrhotic patients who had upper Gastrointestinal Tract (GIT) endoscopy for early varices screening, 160 cirrhotic patients were selected and divided into 2 groups; 80 cirrhotic patients with PHG (cases) and 80 cirrhotic patients without PHG (controls). Gastric biopsies were taken from all enrolled patients for histological evaluation for the presence or absence of <i>H. pylori</i> infection. <i>H. pylori</i> was found in 44 cirrhotic patients (55%) who had PHG (cases), compared to 22 cirrhotic patients (27.5%) who did not have PHG (controls). The prevalence of <i>H. pylori</i> infection was significantly higher in patients with PHG (<i>p</i> < 0.001). The severity of PHG was associated with <i>H. pylori</i> infection (<i>p</i> < 0.001). The response to eradication therapy of <i>H. pylori</i> infection was must better in patients without PHG (<i>p</i> = 0.045). By multi-variant analysis, <i>H. pylori</i> infection, splenic diameter, and portal vein diameter were independent predictors for PHG presence. After treating <i>H. pylori</i> infection in patients who tested positive for <i>H. pylori</i>, there was a significant reduction in PHG severity (<i>p</i> < 0.001). Patients with PHG have a greater prevalence of <i>H. pylori</i> infection. PHG is more severe in patients infected with <i>H. pylori</i>. To improve PHG severity, cirrhotic patients must have their <i>H. pylori</i> infection eradicated.