Study of mucosal and submucosal vasculature, helicobacter pylori and protective capacity of gastric mucosa in portal hypertension

This study was conducted to assess the behaviour of mucosal and submucosal vasculature, protective capacity of gastric mucosa and the presumed aggressive factor, Helicobacter pylori in two well matched groups of patients. Group I included 40 patients with portal hypertension subdivided into: group IA, 20 patients with endoscopic evidence of portal hypertensive gas tropathy and group IB, 20 patients without gastropathy. Group II comprised of 20 control patients with gastritis, not associated with chronic liver disease or portal hypertension. Morphometric study revealed statistically significant increase in the mean value of mucosal and submucosal capillary cross sectional areas in both groups IA and IB as compared to group II, while no statistically significant difference was observed between these two subgroups, although the degree of mucosal and submucosal capillary ectasia was noticed to be more prominent in patients with gastropathy [group IA]. The biochemical studies of the gastric mucus secretion revealed a statistically significant decrease in mucin content, protein component and N-acetyl-neuraminic acid in portal hypertensive patients [group I] as compared to those of gastritis patients [group II]. Helicobacter pylori was found to be a significant aggressive factor in group II patients as compared to group I, it was present in 70% of this group, compared to 35% in group I, 45% in group IA and 25% in group IB. Thus the mechanisms of gastric mucosal changes in portal hypertension are multiple, entailing characteristically gastric mucosal and submucosal capillary ectasia, as well as decreased protective capacity of the gastric mucosa