scholarly journals Is There an Association between Variceal Bleed and Helicobacter pylori Infection in Cirrhotic Patients with Portal Hypertension?

Author(s):  
Sathyanarayan Varuna ◽  
Sathasivam Sureshkumar ◽  
Balakrishnan Gurushankari ◽  
Elangovan Archana ◽  
Subair Mohsina ◽  
...  

Objectives: The objective of this study was to find the association of H. pylori in patients with variceal bleeding as well as rebleeding in cases of cirrhosis with portal hypertension. Methods: This was a prospective cohort of patients with bleeding esophageal varices. The primary outcome was correlation between prevalence of H. pylori and the incidence of bleeding/ rebleeding from varices and with encephalopathy. The secondary outcome were correlation between the site of bleeding with H. pylori infection and the association of pepsinogen I & II and the ratio of pepsinogen I/II with bleeding. Results: A total of 190 patients were assessed for eligibility, out of which 159 patients were included in this study. 124 out of 159 patients (77.9%) had alcohol-related liver disease. 8 out of 159 patients had HBV-related liver disease. 7 patients with varices had neither bled at presentation nor did bleed in the follow-up period. A total of 78 out of 159 (49.05%) patients were H.pylori-infected. Patients with esophageal varices [Adjusted Risk (AR)=0.7] and H.pylori infection (AR=0.7) had a lower risk of variceal rebleeding. Among the patients negative for H.pylori, pepsinogen I was higher in patients with rebleeding (30.7 vs 14.4; p<0.001). Among H.pylori positive patients, the ratio of pepsinogen I/II was higher in patients with rebleeding (2.9 vs 1.3; p=0.023). Conclusion: H.pylori infection was associated with a lower risk of rebleeding in cases of cirrhosis with portal hypertension. Irrespective of the status of H.pylori infection, rebleeding was associated with more gastric acid output demonstrated by the level of pepsinogen. Keywords: Pepsinogen; hepatic encephalopathy; gastric acid output, Helicobacter pylori

Gut ◽  
1997 ◽  
Vol 41 (4) ◽  
pp. 452-458 ◽  
Author(s):  
Y Kinoshita ◽  
C Kawanami ◽  
K Kishi ◽  
H Nakata ◽  
Y Seino ◽  
...  

Background—Gastric acid secretion in Japanese subjects decreases with aging. One of the possible causative mechanisms of this attenuated acid secretion is speculated to be aHelicobacter pylori induced chronic gastritis. The infection rate of this microorganism has decreased recently in Japan.Aims—To investigate whether gastric acid secretion has altered over the past 20 years, and if so, what the influence of H pylori infection might be in the Japanese population.Subjects and methods—Gastric acid secretion, serum gastrin and pepsinogen I and II concentrations, and H pylori infection were determined in 110 Japanese subjects in both the 1970s and 1990s.Results—Basal acid output as well as maximal acid output have greatly increased over the past 20 years, not only in individuals with H pylori infection but also in those without infection. Furthermore, subjects with H pyloriinfection tended to show decreased gastric acid secretion in comparison with those without infection, particularly in geriatric subjects. There was a positive correlation between gastric acid secretion and serum pepsinogen I concentrations.Conclusions—In Japan, both basal and stimulated gastric acid secretion have increased over the past 20 years; some unknown factors other than the decrease in H pylori infection may play an important role in this phenomenon.


Gut ◽  
1999 ◽  
Vol 44 (4) ◽  
pp. 468-475 ◽  
Author(s):  
D Gillen ◽  
A A Wirz ◽  
W D Neithercut ◽  
J E S Ardill ◽  
K E L McColl

BACKGROUNDOmeprazole has a greater intragastric pH elevating effect in Helicobacter pylori positive than negative subjects. Ammonia production byH pylori has been suggested as a probable mechanism.AIMSTo assess the effect ofH pylori status on gastric acid secretion during omeprazole treatment, and to examine the possible role of ammonia neutralisation of intragastric acid in increased omeprazole efficacy in infected subjects.METHODSTwentyH pylori positive and 12H pylori negative healthy volunteers were examined before and six to eight weeks after commencing omeprazole 40 mg/day. On both occasions plasma gastrin and acid output were measured basally and in response to increasing doses of gastrin 17 (G-17). Gastric juice ammonium concentrations were also measured.RESULTSPrior to omeprazole, measurements were similar in the H pyloripositive and negative subjects. During omeprazole, median basal intragastric pH was higher in the H pyloripositive (7.95) versus negative (3.75) subjects (p<0.002). During omeprazole basal, submaximal (180 pmol/kg/h G-17), and maximal acid outputs (800 pmol/kg/h G-17) were lower in H pylori positive subjects (0.0, 3.6, 6.0 mmol/h respectively) versus negative subjects (0.3, 14.2, 18.6 mmol/h) (p<0.03 for each). This effect was not explained by neutralisation by ammonia.CONCLUSIONThe presence ofH pylori infection leads to a more profound suppression of acid secretion during omeprazole treatment. The effect cannot be explained by neutralisation of intragastric acid by bacterial ammonia production and its precise mechanism has to be explained.


1995 ◽  
Vol 108 (4) ◽  
pp. A147
Author(s):  
PH Le Roux ◽  
AW Harris ◽  
MM Walker ◽  
JJ Misiewicz ◽  
JH Baron

Author(s):  
Alonge Ivo Ebule ◽  
Valentine Ngum Ndze ◽  
Ngouana Kammalac Thierry ◽  
Guenou Etienne ◽  
Moche Mboudja Morel Ornella ◽  
...  

Introduction: Helicobacter pylori infection is associated with an atrophic gastritis peptic and duodenal ulcer and gastric cancer. Patients with chronic renal diseases usually have dyspeptic symptoms. Several investigations have demonstrated an association between H. pylori infection and chronic kidney disease, although their results are still conflicting. We therefore aimed, to clarify the prevalence of H. pylori infection in patients receiving dialysis. Materials and Methods: Patients undergoing hemodialysis were recruited at the University Teaching Hospital of Yaounde, between January and May 2019. The clinical and socio-demographic information of the patients was recorded. 5 ml of blood were collected aseptically for Pepsinogen I and II enzymes, gastrin17 hormone and IgG anti H. pylori anti-body. The test parameters were analyzed using a GastroSoft software application. The data was analyzed using Epi Info 7.0. All statistics were 95% CI. Ethical clearance was also obtained from the National Ethics Committee. Authorization was obtained atthe University Teaching Hospital. Results: A total of 60 subjects were recruited aged 25-74 years, (mean±SD 52.03 ± 12,78) years;22(45.16%) females, aged 29 to 71years(mean±SD 47,45 ± 11.46) years and 38(54.84%) males aged 25 to 74 (mean±SD 56,47±12.25) years. Female / male ratio was 1.2. Overall, 26(43.33%) subjects were positive for H. pylori infection (IgG≥30EIU). The prevalence of atrophic gastritis obtained was (23.33%)(PG1< 30µg/l). The mean H. pylori IgG antibodies were significantly higher in obese than non obese subjects (F=3.59; p=0,01). A significant increase in the mean creatinine(P=0.008), andurea (P=0,05) was observed in H. pylori positive than negative ones. Conclusion: H. pylori infection is highly prevalent amongst patients with chronic renal failure and may thus require continuous follow up.


Author(s):  
L. B. Lazebnik ◽  
L. V. Tarasova ◽  
E. A. Komarova ◽  
E. I. Busalayeva

The prevalence of nonalcoholic fatty liver disease (NAFLD) in the world steadily increasеs, turning it into a most prevalent liver disease in the last decade. NAFLD is a multidisciplinary problem, it attracts the attention of specialists of different specialities. Especially interesting is the clarification of the main links of the pathogenesis of nonalcoholic fatty liver disease, including the effect of endogenous microflora on the occurrence and course of disease. Modern information is represented in the review, it confirm the association between Helicobacter pylori infection (H. pylori) and NAFLD. It has been proven that successful eradication of H. pylori detaines the fibrosis in the liver, reduces the level of proinflammatory markers, and improves insulin resistance.


Author(s):  
Alonge Ivo Ebule ◽  
Valentine Ngum Ndze ◽  
Ngouana Kammalac Thierry ◽  
Guenou Etienne ◽  
Chatchweng Kamtchweng Marie Felicite ◽  
...  

Introduction: Helicobacter pylori infection is associated with gastrointestinal diseases including atrophic gastritis and gastric cancer. Epidemiologic studies have demonstrated associations between H. pylori infection andextra gastrointestinal organ involvements including coronary artery disease and peripherical artery disease, dyslipidemia, insulin resistance and hematologic disorders. We sought to evaluate the prevalence of H. pylori infection in patients suffering cardiovascular diseases attending the Yaounde Central Hospital. Materials and Methods: Patients suffering from various cardiovascular complications were recruited at the Yaounde Central Hospital, between January and May 2019. The clinical and socio-demographic information of the patients was recorded. Five ml of blood were collected aseptically for Pepsinogen I and II enzymes, gastrin17 hormone and IgG anti H. pylori anti-body. The test parameters were analyzed using a GastroSoft software application. The data was analyzed using Epi Info 7.0. All statistics were 95% CI. Ethical clearance was also obtained from the National Ethics Committee. The study was accepted by the authorities of the  Yaounde CentralHospital.  All patients signed an informed consent form. Results: A total of 62 subjects were recruited aged 30-75 years, (mean±SD 52.03 ± 12,78 years); 34(54,84%) females aged 30 to 75years (mean±SD 54,47 ± 13,47 years) and 28 (45,16%) males aged 30 to 65,(mean±SD 49,07± 11,44years). Female/male ratio was 1:2.  H. pylori  seropisitivity occurred in 58 (93,55%) of the subjects (IgG ≥30 EIU). H. pylori seropositivity was significantly associated with high blood pressure (RR=2.2 95%C.I 1.67 -2.96, p=0, 024).  Significantly low Triglyceride concentrations were observed in H. pyloripositive(0,51±0,03g/l) compared to negative subjects (1,04 ± 0,50g/l), (p=0.03). A significant inverse correlation was observed between IgG levels and blood glucose levels (r= 0,4  p=0, 004). Conclussion: The study indicates that H. pylori infection is highly associated with various cardiovascular complications and disease risk factors.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Abdelftah Elmaltawy ◽  
Ahmed Saady Khayyal ◽  
Mohamed Osama Aly ◽  
Hisham Ashraf Elhussieny Elghandour

Abstract Background Hepatic Encephalopathy (HE) is defined as alteration of mental state in the absence of other causes of encephalopathy due to liver failure and/or abnormal shunting of blood from portal to systemic circulation often accompanied by elevated blood ammonia. Objectives The aim of this study was to determine the relation between the Helicobacter pylori infectionand minimal hepatic encephalopathy (MHE) in cirrhotic patients and to assess the outcome after treatment of H. pylori. Patients and Methods This study was can•ied out at Egyptian Railway Medical Centre at the in-patients section at Gastroenterology and Hepatology Medicine Department with chronic liver disease who agreed to participate in the study. After performing the psychometric tests the patients were allocated in one of the two groups according to test results: Group I: consisted of 30 consecutive patients who have chronic liver disease and presented with evidence of Minimal hepatic encephalopathy (MHE), as recognized by positive psychometric tests, Group Il: included 30 consecutive patients who presented with chronic liver disease and did not have Minimal hepatic encephalopathy, as confirmed by negative psychometric test. Results In this study a significant reduction was found in blood ammonia levels in MHE and non- MHE after triple-drug anti-H. pylori treatment (p &lt; 0.001). This reduction was more marked in patients with MHE group compared to non-MHE group with % improvement in ammonia level 26.1 ± 8.36 umol/L and 17.79 ± 7.308 for MHE and non-MHE respectively. This finding indicates that H. pylori may contribute to the development of hyperammonemia in patients with liver disease and MHE. The role of H. pylori in the pathogenesis of hyperammonemia has been shown in previous studies which showed a reduction in blood ammonia levels after eradication of H.pylori infection. Conclusion Helicobacter Pylori infection was more prevalent in patients with MHE than without MHE. Serum arnrnonia levels were significantly higher in MHE patients than without MHE and even higher in H.pylori positive patients than without H.pylori infection. Helicobacter Pylori eradication treatment significantly improves ammonia levels, results of psychometric tests and improves manifestations of MHE.


Sign in / Sign up

Export Citation Format

Share Document