Introduction. The occurrence of peptic ulcer in patients with liver cirrhosis
is intriguing due to its frequency and complexity. The aim of the present
study was to investigate the incidence of peptic ulcer in patients with
liver cirrhosis. Results. It was found that in these patients the usual
aggressive factors of the gastric environment do not play a major role in
ulcerogenesis; however, researches noticed the importance of reduced mucosal
defense which, in portal hypertension, has the features of hypertensive
portal gastropathy. The presence of Helicobacter pylori infection in these
patients is lower, compared to other patients with peptic ulcer. The
prevalence of Helicobacter pylori infection decreases with the severity of
liver cirrhosis. Non-steroidal anti-inflammatory drugs play an important
role in peptic ulcer bleeding in cirrhotic patients, but the data are
limited and contradictory. Peptic ulcer bleeding is the most frequent
etiology of nonvariceal bleeding and it is associated with a great number of
complications. Conclusion. Helicobacter pylori infection cannot be
considered the key risk factor for the development of peptic ulcer in
patients with liver cirrhosis. The role of non-steroidal anti-inflammatory
drugs is accepted, although the data are controversial. The treatment of
peptic ulcer in cirrhotic patients is identical to the treatment of peptic
ulcer in patients without liver cirrhosis, except in cases of bleeding
ulcers. There are specific therapeutic protocols for peptic ulcer bleeding
in patients with liver cirrhosis.
Gene structure of the Helicobacter pylori cytotoxin and evidence of its key role in gastric disease.